آنسفالوپاتي كشنده توكسيك يا سندرم ايكايري در اسهال شيگلايي كودكان گزارش سه مورد

Ekiri Syndrome or Lethal Toxic Encephalopathy, Due to Shigella Gastroenteritis in Children: A Case Series

Background and Objective: Ekiri syndrome or lethal toxic encephalopathy is a rare complication of the Shigella gastroenteritis in children. In a period of five years, three cases of this syndrome were reported to the Center for Communicable Disease Control. Case presentation: Three children aged 4, 8 and 9 years with dysentery were hospitalized due to high fever, headache, bloody diarrhea, lethargy and decreased level of consciousness. There were no dehydration and electrolyte abnormalities. Encephalopathy, rapid progression of disease and worsening of conditions resulted in intubation and intensive care in Pediatric Intensive Care Unit (PICU), but they died despite treatment. Stool examination showed red and white blood cells in all cases. Blood cultures were negative but three stool cultures were positive for Shigella and two of them identified as Shigella flexneri. Conclusion: In spite of high mortality, in older children with suspected or confirmed Shigella gastroenteritis, lethargy and headache are the first and predictive signs of lethal toxic encephalopathy. Early diagnosis and appropriate treatment of brain edema can decrease the mortality due to this syndrome. Sci Med J 2010; 9(2):199-203