Gastrointestinal and Extra-Intestinal Manifestations of Childhood Shigellosis in a Region Where All Four Species of Shigella Are Endemic

OBJECTIVE: To determine the clinical manifestations and outcome of shigellosis among children infected with different species of Shigella. METHODS: We identified all patients <15 years infected with Shigella admitted to the icddr, b Dhaka hospital during one year. Study staff reviewed admission records and repeated the physical examinations and history of patients daily. RESULTS: Of 792 children with shigellosis 63% were infected with S. flexneri, 20% with S. dysenteriae type 1, 10% with S. boydii, 4% with S. sonnei, and 3% with S. dysenteriae types 2-10. Children infected with S. dysenteriae type 1, when compared to children infected with other species, were significantly (P<0.05) more likely to have severe gastrointestinal manifestations: grossly bloody stools (78% vs. 33%), more stools in…