Coliform Septicemia Complicating Shigellosis in Children

The rare occurrence of Shigella bacteremia is well known. Septicemia due to other enteric organisms as a secondary event in shigellosis, as far as we know, has not been documented. Three cases of coliform septicemia complicating shigellosis in children are described. Septicemia became manifest on the fifth to sixth day of illness and was characterized by spiking fever, “toxicity,” leukocytosis, and positive blood cultures. Aerobacter species were isolated in all three cases. In one case, Escherichia coli was also present. Two patients responded promptly to antibiotic therapy. One patient developed meningitis and subdural empyema due to an Aerobacter species and died. Coliform septicemia occurring as a secondary event in patients with shigellosis appears to have a distinctive clinical pattern, which should allow its prompt diagnosis and treatment.