Shigellosis of childhood in northern Greece: Epidemiological, clinical andlaboratory data of hospitalized patients during the period 1971-96

The aim of this study was to evaluate epidemiological, clinical and laborat ory data of shigellosis in children from northern Greece, hospitalized in o ur department during the period 1971-96, In total, 422 cases of shigellosis , aged 1 month to 14 y (238M, 184F) were hospitalized during the study peri od. The annual distribution was approximately stable until 1990, the mean n umber of cases per year being about 20, During the last 4 y the incidence s ignificantly decreased. Shigella was serotyped in 138/422 cases. Seventy si x of the strains were S. flexneri (55%) and 56 S. sonnei (40%). In the majo rity of cases the clinical picture was mild. Severe dehydration was seen in only 6 patients. Ninety four patients (22%) had extra-intestinal manifesta tions. Most common of these were convulsions (16%) and, less frequently, di sturbances of consciousness (n = 26), rash (n = 9), shock and disseminated intravascular coagulopathy (n = 2), nerve paralysis (n = 2), severe anaemia (n = 2) and haemolytic-uraemic syndrome (n = 1), Nine patients had acute e ncephalopathy of 12 h to 12 d duration. It is important to note that all Th ese cases recovered completely with no residual neurological deficit, excep t for 1 girl who developed temporal epilepsy 8 y later. Spinal fluid was no rmal in all 42 examined patients. Antibiotics were given to 212 of 422 pati ents, mainly during the first half of the study period. Shigella resistance to antibiotic was significant for cotrimoxazole (24%) and ampicillin (16%) . All patients were cured. Shigellosis is a mild disease in our area, with a decreasing prevalence.