# Shigella flexneri 1c bacteremia in a child: a case report

## TL;DR

A rare case of Shigella flexneri 1c bacteremia in a young child is reported, highlighting the importance of early diagnosis and treatment.

## Contribution

This is the first report of S. flexneri serotype 1c bacteremia in Iran with identified virulence factors.

## Key findings

- A 13-month-old child presented with Shigella flexneri 1c-induced dysentery and bacteremia.
- The patient was successfully treated with gentamicin and ciprofloxacin after failing ceftriaxone.
- The isolate harbored multiple virulence factors including ipaB, ipaC, ipaD, ipaH, ipgD, virA, and sen.

## Abstract

Shigellosis is a significant public health issue in developing countries, particularly affecting young children under the age of five. While it primarily causes gastrointestinal infections, there are rare complications, such as bacteremia, that mainly occur in young children. We present a case of dysentery caused by Shigella flexneri serotype 1c, followed by bacteremia.

A 13-month-old Afghan child presented with fever, dysentery, distended abdomen, mild tenderness, and dehydration. He did not respond to empirical treatment with ceftriaxone. However, he was successfully treated with a combination of gentamicin and ciprofloxacin. This is the first report of a patient in Iran who was positive for S. flexneri serotype 1c and harbored the ipaB, ipaC, ipaD, ipaH, ipgD, virA, and sen virulence factors.

This case alerts clinicians to consider the possibility of Shigella bacteremia in young children. Early and accurate diagnosis can improve management and prognosis to reduce the risk of fatality outcomes. Additionally, it emphasizes the need to characterize the role of Shigella spp. virulence genes in causing bacteremia.