Frontiers in Environmental Microbiology

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Shigillosis with Acute Appendicitis and Peritonitis: A Case Report

Received: 15 September 2020    Accepted: 17 October 2020    Published: 04 November 2020
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Abstract

Shigellosis is a form of bacterial diarrhea caused by gram-negative bacteria Shigella species. It is common in developing countries and results from contaminated food, poor sanitation conditions, or direct person to person contact. Shigella can cause infection in all age groups. High-risk group include very young, elderly, and immunocompromised person. Shigella species is relatively resistant to acid in the stomach, and few organisms are required to cause the disease. Once ingested, it multiplies in the small intestine and enters the colon. In the colon, it produces shigella enterotoxins and serotype toxin 1, resulting in watery or bloody diarrhea. Clinical presentation of shigellosis may vary over a wide spectrum from mild diarrhea to severe dysentery. We report the case of 7 years old previously healthy boy, who presented to our hospital with abdominal pain, vomiting, and constipation. On examination, we noticed abdominal tenderness with guarding at the right lower quadrant. With the diagnosis of acute appendicitis, open appendectomy was performed. Exploration of the abdominal cavity revealed perforated appendicitis and generalized peritonitis. Shigella sonnei was isolated from the peritoneal fluid culture. The patient completely recovered without any complications. Surgical complications, including appendicitis, could have developed during shigellosis. There are few reported cases of perforated appendicitis associated with Shigella. Prompt surgical intervention can be beneficial to prevent morbidity and mortality if it is performed early in the course of the disease.

DOI 10.11648/j.fem.20200604.11
Published in Frontiers in Environmental Microbiology (Volume 6, Issue 4, December 2020)
Page(s) 52-55
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Shigella Sonnei, Acute Appendicitis, Peritonitis, Surgical Complication

References
[1] Du Pont HL. Shigella species (Bacillary dysentery). In: MandellGL, Bennett JE, Dolin R, eds. Mandell, Douglas and Bennett’s principles and practice of infectious diseases. Philadelphia: Churchill Livingstone; 2010. pp. 2905-10.
[2] Miron D, Sochotnick I, Yardeni D, Kawar B, Siplovich L. Surgical complications of shigellosis in children. Pediatr Infect Dis J 2000; 19: 898-900.
[3] Gülsüm İclal Bayhan, Unusual Presentation of Shigellosis: Acute Perforated Appendicitis and Peritonitis: J Pediatr Inf 2015; 9: 45-8.
[4] Prado V, Lagos R, Nataro JP, et al: Population-based study of the incidence of Shigella diarrhea and causative serotypes in Santiago, Chile. Pediatr Infect Dis J 18: 500-505, 1999.
[5] Ashkenazi S, Levy I, Kazaronovski V, et al: Growing antimicrobial resistance of Shigella isolates. J Antimicrob Chemother 51: 427-429, 2003.
[6] Ashkenazi S. Shigella infections in children: New insights. Semin Pediatr Infect Dis 2004; 15: 246-52.
[7] Bennish ML. Potentially lethal complications of shigellosis. Rev Infect Dis 1991; 13: 319-24.
[8] Sifri CD, Madoff LC. Appendicitis In: Mandell GL, BennettJE, Dolin R, eds. Mandell, Douglas and Bennett’s principles and practice of infectious diseases. Philadelphia: Churchill Livingstone; 2010. p. 1059-62.
[9] Jain S, Sharma M, Gupta R, Shree N, Kumar M. Multidrug resistant Shigella flexneri: A rare case of septicaemia in an infant. Journal of Clinical and Diagnostic Research. 2014; 8 (6): 03-04.
[10] Kamble R. Bacteraemia due to Shigella flexneri in an adult. Int J Curr Microbiol App Sci. 2015; 4 (4): 870-73.
[11] Sebhat AE, Teferra E, Mulu A, Kassu A. A case of shigellosis with intractable septic shock and convulsions. Jpn J Infect Dis. 2007; 60: 314-16.
[12] Pappas G, Kiriaze IJ, Falagas ME. Insights into infectious disease in the era of Hippocrates. Int J Infect Dis 2008; 12: 347-50.
[13] White ME, Lord MD, Rogers KB. Bowel infection and acute appendicitis. Arch Dis Child 1961; 36: 394-9.
[14] Leigh DA, Simmons K, Norman E. Bacterial flora of the appendix fossa in appendicitis and postoperative wound infection. J Clin Pathol 1974; 27: 997-1000.
[15] Lending RE, Buchsbaum HW, Hyland RN. Shigellosis complicated by acute appendicitis. South Med J 1986; 79: 1046-7.
[16] Tovar JA, Trallero EP, Garay J. Appendiceal perforation and shigellosis. Z Kinderchir 1983; 38: 419.
[17] Doran A, Sunderland GT, Livingstone PD. Appendicitis associated with Shigella sonnei dysentery. J R Coll Surg Edinb 1987; 32: 249.
[18] Nussinovitch M, Shapiro RP, Cohen AH, Varsano I. Shigellosis complicated by perforated appendix. Pediatr Infect Dis J 1993; 12: 352-3.
[19] Hamadani JD, Azad MT, Chowdhury JJ, Kabir I. Intestinal perforation in a child with Shigella dysenteriae type 1 infection: a rare complication. J Diarrhoeal Dis Res 1994; 12: 225-6.
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Author Information
  • Faculty of Medicine and Pharmacy, University of Cadi Ayyad, Marrakesh, Morocco; Department of Microbiology, University Hospital Center Mohamed VI, Marrakesh, Morocco

  • Faculty of Medicine and Pharmacy, University of Cadi Ayyad, Marrakesh, Morocco; Department of Microbiology, University Hospital Center Mohamed VI, Marrakesh, Morocco

  • Faculty of Medicine and Pharmacy, University of Cadi Ayyad, Marrakesh, Morocco; Department of Microbiology, University Hospital Center Mohamed VI, Marrakesh, Morocco

  • Faculty of Medicine and Pharmacy, University of Cadi Ayyad, Marrakesh, Morocco; Department of Microbiology, University Hospital Center Mohamed VI, Marrakesh, Morocco

  • Faculty of Medicine and Pharmacy, University of Cadi Ayyad, Marrakesh, Morocco; Department of Microbiology, University Hospital Center Mohamed VI, Marrakesh, Morocco

  • Faculty of Medicine and Pharmacy, University of Cadi Ayyad, Marrakesh, Morocco; Department of Infant Surgery, University Hospital Center Mohamed VI, Marrakesh, Morocco

  • Faculty of Medicine and Pharmacy, University of Cadi Ayyad, Marrakesh, Morocco; Department of Microbiology, University Hospital Center Mohamed VI, Marrakesh, Morocco

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  • APA Style

    Raihane Bahri, Hajar Saffour, Fadoua Elfarssani, Saida Eddyb, Asma Amrani, et al. (2020). Shigillosis with Acute Appendicitis and Peritonitis: A Case Report. Frontiers in Environmental Microbiology, 6(4), 52-55. https://doi.org/10.11648/j.fem.20200604.11

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    ACS Style

    Raihane Bahri; Hajar Saffour; Fadoua Elfarssani; Saida Eddyb; Asma Amrani, et al. Shigillosis with Acute Appendicitis and Peritonitis: A Case Report. Front. Environ. Microbiol. 2020, 6(4), 52-55. doi: 10.11648/j.fem.20200604.11

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    AMA Style

    Raihane Bahri, Hajar Saffour, Fadoua Elfarssani, Saida Eddyb, Asma Amrani, et al. Shigillosis with Acute Appendicitis and Peritonitis: A Case Report. Front Environ Microbiol. 2020;6(4):52-55. doi: 10.11648/j.fem.20200604.11

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  • @article{10.11648/j.fem.20200604.11,
      author = {Raihane Bahri and Hajar Saffour and Fadoua Elfarssani and Saida Eddyb and Asma Amrani and Mohamed Oulad Siad and Nabila Soraa},
      title = {Shigillosis with Acute Appendicitis and Peritonitis: A Case Report},
      journal = {Frontiers in Environmental Microbiology},
      volume = {6},
      number = {4},
      pages = {52-55},
      doi = {10.11648/j.fem.20200604.11},
      url = {https://doi.org/10.11648/j.fem.20200604.11},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.fem.20200604.11},
      abstract = {Shigellosis is a form of bacterial diarrhea caused by gram-negative bacteria Shigella species. It is common in developing countries and results from contaminated food, poor sanitation conditions, or direct person to person contact. Shigella can cause infection in all age groups. High-risk group include very young, elderly, and immunocompromised person. Shigella species is relatively resistant to acid in the stomach, and few organisms are required to cause the disease. Once ingested, it multiplies in the small intestine and enters the colon. In the colon, it produces shigella enterotoxins and serotype toxin 1, resulting in watery or bloody diarrhea. Clinical presentation of shigellosis may vary over a wide spectrum from mild diarrhea to severe dysentery. We report the case of 7 years old previously healthy boy, who presented to our hospital with abdominal pain, vomiting, and constipation. On examination, we noticed abdominal tenderness with guarding at the right lower quadrant. With the diagnosis of acute appendicitis, open appendectomy was performed. Exploration of the abdominal cavity revealed perforated appendicitis and generalized peritonitis. Shigella sonnei was isolated from the peritoneal fluid culture. The patient completely recovered without any complications. Surgical complications, including appendicitis, could have developed during shigellosis. There are few reported cases of perforated appendicitis associated with Shigella. Prompt surgical intervention can be beneficial to prevent morbidity and mortality if it is performed early in the course of the disease.},
     year = {2020}
    }
    

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    T1  - Shigillosis with Acute Appendicitis and Peritonitis: A Case Report
    AU  - Raihane Bahri
    AU  - Hajar Saffour
    AU  - Fadoua Elfarssani
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    JO  - Frontiers in Environmental Microbiology
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    AB  - Shigellosis is a form of bacterial diarrhea caused by gram-negative bacteria Shigella species. It is common in developing countries and results from contaminated food, poor sanitation conditions, or direct person to person contact. Shigella can cause infection in all age groups. High-risk group include very young, elderly, and immunocompromised person. Shigella species is relatively resistant to acid in the stomach, and few organisms are required to cause the disease. Once ingested, it multiplies in the small intestine and enters the colon. In the colon, it produces shigella enterotoxins and serotype toxin 1, resulting in watery or bloody diarrhea. Clinical presentation of shigellosis may vary over a wide spectrum from mild diarrhea to severe dysentery. We report the case of 7 years old previously healthy boy, who presented to our hospital with abdominal pain, vomiting, and constipation. On examination, we noticed abdominal tenderness with guarding at the right lower quadrant. With the diagnosis of acute appendicitis, open appendectomy was performed. Exploration of the abdominal cavity revealed perforated appendicitis and generalized peritonitis. Shigella sonnei was isolated from the peritoneal fluid culture. The patient completely recovered without any complications. Surgical complications, including appendicitis, could have developed during shigellosis. There are few reported cases of perforated appendicitis associated with Shigella. Prompt surgical intervention can be beneficial to prevent morbidity and mortality if it is performed early in the course of the disease.
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