POLYMICROBIAL AND RECURRENT BACTEREMIA WITH SHIGELLA IN A PATIENT WITH AIDS

Shigella gastroenteritis is uncommon among HIV seropositive patients a nd may be complicated in some patients by bacteremia; S. flexneri bein g the most frequently detected serogroup. While recurrent Salmonella b acteremia is common among HIV-seropositive patients, recurrent Shigell a bacteremia is not. We report here an HIV-seropositive patient with S higella gastroenteritis, polymicrobial bacteremia due to S. flexneri a nd S. boydii, and recurrent gastroenteritis and bacteremia with S. boy dii. Relapsing infection with the same strain of S. boydii was determi ned using pulsed field gel electrophoresis. Thus, HIV-seropositive pat ients who develop Shigella infections may require prolonged treatment and/or suppressive therapy, similar to those infected with Salmonella. Patients who develop recurrent disease should be suspected as having polymicrobial bacteremia since the incidence of this may be underestim ated among patients with AIDS, particularly those with concurrent gast roenteritis.