Neurological manifestations of shigellosis in children in southwestern Iran.

BACKGROUND

Shigella spp. are important causative agents of acute diarrhea and dysentery. Neurological signs are among the most common extraintestinal manifestation of shigellosis. The aim of this study was to determine the relative frequency of neurological signs in children with shigellosis in southwestern Iran.

METHODS

In a retrospective study, the medical records of all children suffering from shigellosis who had been admitted to Abuzar Children's Hospital in Ahvaz, southwestern Iran, from March 2006 to March 2009 were reviewed. The epidemiological characteristics, clinical findings, and laboratory data of the patients with shigellosis were analyzed. The statistical analysis was performed using SPSS version 13.0 software.

RESULTS

During the study period, 154 children suffering from shigellosis were admitted. Of the patients studied, 85 (55.2%) were male and 69 (44.8%) female. The majority of patients were in the age group of 1-4 years. A total of 129 children (83.3%) had fever; dysentery was the presenting complaint of 43 (27.9%) of the patients. Shigella sonnei was isolated from 77 cases (50%), Shigella flexneri from 59 (38.2%), Shigella boydii from 11 (7.1%), and Shigella dysenteriae from seven (4.5%). Neurological manifestations were observed in 106 (68.8%) of the children. There were no statistically significant associations between the presences of neurological manifestations and sex, age, leukocytosis, bandemia, electrolyte imbalance or species of Shigella. The associations between neurological manifestations and the presence of fever and dysentery were statistically significant.

CONCLUSIONS

Shigella sonnei was the most common species of Shigella in southwestern Iran. Neurological manifestations were common in the children with shigellosis. Fever and dysentery were significant risk factors for the development of neurological signs.