Sodium and water homeostasis in children with shigellosis

Lindblad, HG; Berg, U; Dhar, Ujjwal; Mahalanabis, Dilip; Salaam, MA; Zetterström, Rolf

doi:10.1111/j.1651-2227.2001.tb01599.x

Cited by 4 publications

(1 citation statement)

References 26 publications

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“…Children with shigellosis often develop the syndrome of inappropriate antidiuretic hormone secretion (SIADH) which is manifested by hyponatraemia and hypo‐osmolality because of inappropriate, continued secretion or action of the antidiuretic despite normal or increased plasma volume that later on causes impaired water excretion[43]. Although Campylobacter is considered as a key triggering agent for an acute immune‐mediated polyneuropathy (GBS) [44, 45], but Campylobacter may not be able to trigger convulsion in children [3].…”

Section: Discussionmentioning

confidence: 99%

Pathogen‐specific risk of seizure in children with moderate‐to‐severe diarrhoea: Case control study with follow‐up

Afroze

Das

Ahmed

et al. 2020

Tropical Med Int Health

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Objective To determine the pathogen‐specific risk of seizure in under‐five children hospitalised with moderate‐to‐severe diarrhoea (MSD) in rural settings. Method This was a prospective case–control study with follow‐up, conducted in a sentinel facility of Global Enteric Multicenter Study in Mirzapur, a rural community of Bangladesh between 2007 and 2010. Children aged 0–59 months who presented with MSD and seizure constituted the cases whereas those who did not have seizure comprised the controls. MSD was defined if the episodes were associated with dehydration or dysentery or required hospitalisation with diarrhoea or dysentery. All enrolled children were followed up at home within 50–90 days of enrolment. A total of 64 cases and 128 randomly selected controls formed the analysable dataset. Results The result of logistic regression analysis after adjusting for potential confounders revealed that shigellosis (Shigella species, OR = 5.34, 95% CI = 2.37–12.04) particularly S. flexneri (OR = 3.34, 95% CI = 1.48–7.57), S. flexneri 6 (OR = 23.24, 95% CI = 2.79–193.85), S. sonnei (OR = 6.90, 95% CI = 2.34–19.85); norovirus (OR = 6.77, 95% CI = 1.69–27.11), fever (OR = 16.75, 95% CI = 1.81–154.70) and loss of consciousness (OR = 35.25, 95% CI = 1.71–726.20) were the independent risk factors for seizure in MSD children. At enrolment, cases had lower WHZ (P = 0.006) compared to their peers, follow‐up anthropometrics showed significant improvement in WHZ (P < 0.001) and WAZ (P < 0.05), whereas deterioration in HAZ (P < 0.001) in both cases and controls. Conclusion Childhood MSD episodes particularly due to Shigella and norovirus are often associated with seizure. Prompt identification and appropriate management of children with shigellosis may reduce occurrence and adverse consequences of seizure linked with MSD.

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Section: Discussionmentioning

confidence: 99%

Pathogen‐specific risk of seizure in children with moderate‐to‐severe diarrhoea: Case control study with follow‐up

Afroze

Das

Ahmed

et al. 2020

Tropical Med Int Health

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Risk factors and outcome of Shigella encephalopathy in Bangladeshi children

et al. 2017

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BackgroundAlthough, Shigella encephalopathy, a serious extra-intestinal complication of shigellosis, significantly increases the risks of death, data are very limited on predicting factors particularly related to electrolyte profiles in children below five years of age with Shigella encephalopathy. Our objective was to determine the clinical as well as laboratory predicting factors and outcome of children with Shigella encephalopathy.Methodology/Principal findingsIn this unmatched case-control design, children aged 2–59 months having a positive stool culture for Shigella and who had their serum electrolytes been done from July 2012 to June 2015 were studied. Children with Shigella encephalopathy, defined as having abnormal mentation, constituted the cases, and those without encephalopathy constituted the controls. During the study period, we identified a total of 541 children less than five years of age, who had Shigella in their stool culture. Only 139 children fulfilled the study criteria and among them 69 were cases and 70 were controls. The cases more often had fatal outcome compared to the controls (7% vs. 0%, P = 0.02). In logistic regression analysis, the cases were independently associated with shorter duration (1.2 ± 0.4 days) of diarrhea prior to admission, dehydrating diarrhea, sepsis and hyponatremia (p<0.05 for all). Among 139 Shigella isolates, S. flexneri (88/139, 63%) and S. sonnei(34/139, 24%) were the dominant species. S. dysenteriae was not isolated throughout the study period. S.sonnei was more frequently isolated from the cases (24/69, 35%) than the controls (10/70, 14%), whereas the isolation of S. flexneri was comparable between the groups (40/69, 58% vs 48/70, 69%). A total of 94 (67.6%) isolates were resistant to trimethoprim-sulphamethoxazole, 84 (60.4%) to ciprofloxacin, 66/138 (48%) to ampicillin, 5 (3.5%) to ceftriaxone, 17 (12.2%) to mecillinum and 35 (25%) to azithromycin.Conclusions/SignificanceThe case-fatality-rate was significantly higher among the children with Shigella encephalopathy compared to those without encephalopathy. Early identification and aggressive management of simple risk factors for Shigella encephalopathy may help to reduce morbidity and deaths in such children especially in resource-limited settings.

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