What is the mortality and morbidity associated with shigellosis?

Updated: Aug 20, 2021
  • Author: Heba Rashid Ashraf, MD; Chief Editor: BS Anand, MD  more...
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Answer

Infection with Shigella species may be associated with extragastrointestinal complications.

  • Bacteremia occurs primarily in malnourished children and carries a mortality rate of 20% as a result of renal failure, hemolysis, thrombocytopenia, gastrointestinal hemorrhage, and shock. [22, 17]

  • Hemolytic uremic syndrome may complicate infections with Shigella species and Escherichia coli, and it carries a mortality rate of greater than 50%. [12] Hemolytic uremic syndrome is characterized by acute hemolysis, renal failure, uremia, and disseminated intravascular coagulation.

  • Metabolic disturbances: Hyponatremia secondary to the syndrome of inappropriate antidiuretic hormone (ADH) secretion may occur.

  • Leukemoid reaction: An elevated WBC count of 50,000/mm3 occurs in approximately 4% of patients, mainly in pediatric patients aged 2-10 years.

  • Neurologic disease: Seizures, the most common neurologic complication, are always associated with fever and are generalized. They are typically nonrecurring and uncomplicated. Seizures are least common with S dysenteriae. The prevalence of seizures is approximately 10% across all ages.

  • Encephalopathy with lethargy, confusion, and headache has been noted in up to 40% of children hospitalized with Shigella infections.

  • Reactive arthritis (also known as Reiter syndrome) may occur.


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