Lethal toxic encephalopathy due to childhood shigellosis in a developed country.

摘要: Shigellosis results in considerable morbidity endemic areas, but mortality is rare developed countries. All pediatric deaths (n = 15) Israel following shigellosis the past 10 years were reviewed. The patients' ages ranged from 5 months to 11 years; there eight boys and seven girls. Three institutionalized mentally retarded patients, healthy children. Twelve had definite clinical signs of brain death within 48 hours onset disease. Cause all patients was consistent with toxic encephalopathy. No other systemic complication implicated as cause except for one case a "Reye-like" syndrome. Shigella species follows: 8 flexneri, 4 sonnei, 1 dysenteriae, 2 not identified. Case-control study these vs surviving, hospitalized showed similar severity fever, diarrhea, vomiting, dehydration incidence convulsions. Headache prominent feature who died; 7 verbal complained this symptom opposed 20 control group (P less than .01). There no significant differences hematological biochemical profile (except an increased hyponatremia group), pattern shigella species, or antibiotic sensitivity. These findings indicate that country due primarily encephalopathy