Nahid Hiwa, Staub Désirée, Hächler Herbert, Albrich Werner C
Division of General Internal Medicine, Kantonsspital Sankt Gallen, Rorschacher Str. 95, 9007, Sankt Gallen, Switzerland.
National Centre for Enteropathogenic Bacteria and Listeria (NENT), Institute for Food Safety and Hygiene, Vetsuisse Faculty University of Zürich, Zurich, Switzerland.
Infection. 2017 Apr;45(2):241-244. doi: 10.1007/s15010-016-0967-y. Epub 2016 Dec 1.
Pneumonia caused by shigellosis with or without typical dysentery in immunocompetent patients is an uncommon entity.
We describe a case of pneumonia in an immunocompetent, previously healthy middle-aged man from Switzerland without relevant travel history which was presumably caused by Shigella sonnei. He was originally admitted for suspected lung cancer. The clinical picture was remarkable as the patient presented with cough and purulent sputum production, but otherwise no classical signs of pneumonia. Furthermore, there was no diarrhoeal episode in the recent history. It is an uncommon presentation of shigellosis in an immunocompetent person without underlying severe predisposing conditions.
We report an unusual identification of S. sonnei as the only identified pathogen from respiratory specimens, which we therefore consider the most likely etiology of this subacute atypical pneumonia. This case illustrates the importance of a complete work-up in a patient whose suspected malignancy could not be proven.