Background: Shigellosis is one of the leading causes of mortality and morbidity among children less than five years (under-5 children). Available literature report Atypical serotypes of Shigella flexneri from various parts of the world. At present, there are 17 serotypes in S. dysenteriae, 6 serotypes and 14 subserotypes in S. flexneri, 20 serotypes in S. boydii and a single serotype of S.sonnei, 2 phases and 5 biotypes (a, b, e, f and g). Here, we report a strain of mannitol non-fermenting S.flexneri serotype 4 in a one-year-old girl child presented with high-grade fever and loose stools.Clinical Description: A one-year-old girl child with a known history of absence seizures presented with high-grade fever and loose stools for two days, about 8-9 episodes per day, foul-smelling, mucoid in nature, stained with fresh blood, and abdominal pain. The child also had 2-3 episodes of vomiting, non-bilious, non-blood-stained and contained food particles. Stool sample was plated onto MacConkey agar (MAC) and Xylose Lysine Deoxycholate Agar (XLD agar) and incubated aerobically at 37°C for 16-18 hours.Non lactose fermenting and red colonies were seen in MAC and XLD respectively which was identified subsequently as Shigella flexneri by serogrouping, but was a mannitol non fermentor. The isolate was found to harbour multiple virulence genes by PCR. Conclusion:The child was continued on oral cefixime for 10 days but has not improved following which she was started on Inj. Ceftriaxone 100 mg/kg/day for 5 days and the child improved and discharged subsequently.
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