A Fatal Case of Shigellosis in an Elderly Patient

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  • IMAMURA Shigeki
    Departments of Integrated Medicine, Tokyo Metropolitan Komagome Hospital
  • OKAMOTO Tomomi
    Departments of Integrated Medicine, Tokyo Metropolitan Komagome Hospital
  • MASUDA Gohta
    Infectious Diseases, Tokyo Metropolitan Komagome Hospital

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Other Title
  • 急速な経過を辿り死亡した赤痢菌感染症の1例
  • 臨床 急速な経過を辿り死亡した赤痢菌感染症の1例
  • リンショウ キュウソク ナ ケイカ オ タドリ シボウ シタ セキリキン カンセンショウ ノ 1レイ

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Abstract

A 71 year-old male, with no recent history of travelling abroad and a past history of lung cancer two years prior to presentation, which had been successfully treated, developed a sudden onset of watery diarrhea more than ten times a day on February 26, 2001, which gradually became bloody. The next day he visited the Department of Integrated Medicine of the Tokyo Metropolitan Komagome Hospital by ambulance because his conciousness was deteriorating and he was hospitalized. He was hypotensive on admission, and a dopamine preparation was used throughout. The peripheral WBC was 3, 800/μl and the lymphocyte count was 76/μl which thus suggested the presence of cellular immune suppression. HIV was nottested. He died seven hours after admission. His stool culture yielded a growth of Shigella flexneri 2a, and a blood culture on admission was sterile. No verocyte toxin-producing Esherichia coil was not detected. The causes of death in cases with shigellosis have been reported in the literature to be an electrolyte imbalance, septicemia and disseminated intravasucular coagulation (DIC) in developed countries. Our present case was considered to be a debilitated patient complicated with hemolytic uremic syndrome due to an infection with Shigella bacteria which resulted in death despite performing intensive treatments.

Journal

  • Kansenshogaku Zasshi

    Kansenshogaku Zasshi 76 (6), 466-469, 2002

    The Japanese Association for Infectious Diseases

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