Whereas shigellosis is a common disease entity affecting nearly 450,000 persons each year in the United States, Shigella bacteremia is a rare finding. Most reported cases in adults involve an underlying chronic condition conferring immunosuppression such as human immunodeficiency virus (HIV) infection. We believe this case is the first reported of Shigella bacteremia in a patient infected with both HIV and acute hepatitis B. The patient presented with diarrhea, dehydration, and fever. Shigella was isolated from blood but not stool. Both HIV and acute hepatitis B infection were discovered during hospitalization. The patient recovered quickly with fluid resuscitation and antibiotics. The exact predisposing factors which led to the development of Shigella bacteremia in this patient are unknown, however, we speculate that HIV and acute hepatitis B coinfection may have increased susceptibility to Shigella.
From the Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA.
Reprints: Bennett S. Shenker, MD 1015 Walnut St., 401 Curtis, Philadelphia, PA 19107. E-mail: Bennett.Shenker@mail.tju.edu.