# From Diarrhea to Bacteremia: Extended-Spectrum Beta-Lactamase (ESBL)-Producing Shigella in a Rare Clinical Scenario

## TL;DR

A rare case of blood infection caused by drug-resistant Shigella in an otherwise healthy man is reported, highlighting the need for prompt diagnosis and targeted treatment.

## Contribution

This paper presents a rare clinical case of ESBL-producing Shigella sonnei causing bacteremia in an immunocompetent adult.

## Key findings

- Shigella sonnei with ESBL production was confirmed in both stool and blood cultures.
- The patient was successfully treated with ertapenem and made a full recovery.
- The case emphasizes the importance of early diagnosis and targeted antimicrobial therapy for drug-resistant strains.

## Abstract

Though globally prevalent, Shigella infections rarely progress to bacteremia (shigellemia), particularly in immunocompetent individuals. Here, we report a case of shigellemia with extended-spectrum beta-lactamase (ESBL) in Qatar, involving a 53-year-old immunocompetent male with no significant medical history. The patient presented with a one-day history of frequent loose stools, fever, and mild central abdominal pain. Stool and blood cultures confirmed Shigella sonneiinfection and shigellemia with ESBL production. The patient tested negative for human immunodeficiency virus (HIV), had normal immunoglobulin levels, and was successfully treated with a 10-day course of ertapenem, achieving full recovery. This case underscores the importance of considering shigellemia in patients with severe gastrointestinal symptoms, even without immunosuppression. It highlights the need for prompt diagnosis, antibiotic susceptibility testing, and targeted antimicrobial therapy, especially given the rising prevalence of antibiotic-resistant strains. A thorough investigation of predisposing factors and patient education on hygiene practices remains essential to prevent transmission and mitigate community outbreaks.