Pneumonia complicating Shigella sonnei dysentery in an HIV-infected adult male

Abstract

An HIV-1-infected adult presented with a short history of dyspnoea, productive cough and myalgia with fever. Shortly after presentation, he developed the abrupt onset of high-volume watery diarrhoea: stool culture grew Shigella sonnei. At the same time, he became hypoxaemic, and thoracic imaging showed bilateral lower lobe consolidation/collapse. Culture of sputum and blood was negative. The patient recovered with fluid resuscitation and ciprofloxacin monotherapy. This is the first reported case of pneumonia complicating S. sonnei dysentery in an HIV-infected adult.

Case-Control Study of Shigellosis in San Francisco: The Role of Sexual Transmission and HIV Infection

“…Finally, it is possible that knowledge of the discordant HIV status of sex partners may promote the substitution of behaviors that increase the risk of transmitting HIV with behaviors that increase the risk of transmitting enteric pathogens. Some case reports and case series suggest more-severe shigellosis among HIV-infected patients [26][27][28][29][30][31]. One case-control study from Zambia, conducted during an epidemic of dysentery (most of it due to S. dysenteriae), found an association between dysentery and HIV infection (crude OR, 9.2; 95% CI, 5.0-16.9) [32].…”

Shigellosis: Epidemiology in India

“…In Senegal, Shigella was implicated as the most common cause (12.4%) of diarrhoea in immunocompetent adults but in immunocompromised individuals Shigella was fifth most common (7.6%)51. Shigellosis, presents as a more severe infection in HIV infected individuals, may cause bacteraemia and unusual features like keratitis and pneumonia, fail to respond to appropriate therapy thus requiring prolonged treatment, and may recur after completion of treatment 52 53 54 .…”

“…Bacteraemia may be reported in infants and immunocompromised adults 56 . Pneumonia associated with S. sonnei has also been described in malnourished children, in HIV infected patients, and in patients with chronic diseases 54 57 .…”

International Laws and Food-Borne Illness

“…Untreated cases of Shigella dysentery may become severe and cause anorexia, hemolytic-uremic syndrome, dilation of large intestine, kidney damage, weight loss, and seizures (Sur et al, 2004). Bacteremia is also reported in HIV-infected patients and malnourished children (Miller et al, 2005).…”