Fulminant encephalopathy due to Shigella flexneri

In some rare cases, Shigella flexneri infection may be associated with fulminating encephatopathy. A 6-year-old girl was admitted with fever, diarrhea and consciousness abnormalities. Brain CT scan was normal. Shigella flexneri type 2 was isolated from the stools. Despite antibiotic therapy, the encephalopathy was lethal. Two siblings were also infected, the first with only diarrhea, the second with headache and mild consciousness abnormalities: both children had a favorable course. Shigella flexneri encephalopathy is associated with high mortality rate in developed countries. Presence of headache could be a poor prognostic factor.