Two Cases of Vulvovaginitis Caused by Shigella flexneri and Shigella sonnei: a Case Report

Abstract

Vulvovaginitis caused by Shigella species (Shigella spp.) has rarely been reported. This paper describes two cases of prepubertal vulvovaginitis, presenting with a bloody and purulent vaginal discharge, separately caused by ampicillin-resistant Shigella flexneri and trimethoprim-sulfomethoxazoleresistant Shigella sonnei. Our conclusions are that Shigella spp. is the potential cause of vulvovaginitis in prepubertal girls in developing countries where these pathogens are endemic, and identification of the bacteria and making antibiotic susceptibility testing in these cases should not be overlooked. Turkish Başlık: Shigella Flexneri ve Shigella Sonnei'nin Neden Olduğu İki Vulvovajinit Olgusu: Olgu Sunumu Anahtar Kelimeler: Shigella flexneri, Shigella sonnei, vulvovajinit, prebubertal kız çocukları Shigella species (Shigella spp.)'in neden olduğu vulvovajinitler nadir olarak bildirilmiştir. Burada kanlı irinli vaginal akıntı şikayeti ile başvuran ve birinde ampisilin dirençli Shigella flexneri ve diğerinde trimetoprim-sulfametoksazole dirençli Shigella sonnei tespit edilen prebubertal vulvovajinitli iki olgu sunulmaktadır. Bulgularımız kuvvetle düşündürmektedir ki özellikle bu patojenlerin endemik olduğu gelişmekte olan ülkelerde vulvovajiniti olan prebubertal kız çocuklarında Shigella spp.'nin tanımlanması ve antibiyotik duyarlılık testi göz ardı edilmemelidir.

Keywords

• Shigella flexneri, Shigella sonnei, vulvovaginitis, prepubertal girls

Two Cases of Vulvovaginitis Caused by Shigella flexneri and Shigella sonnei: a Case Report

Abstract

References

1. 1. Ashkenazi S. Shigella infections in children: new insights. Semin Pediatr Infect Dis 2004;15:246-52. [CrossRef]
2. 2. Farmer JJ. Enterobacteriaceae: introduction and identification. In: Murray PR, Baron EJ, Jorgensen JH, Pfaller MA, Yolken RH, editors. Manual of clinical microbiology. 8th ed. Washington DC: American Society for Microbiology; 2003. p. 636-53.
3. 3. Mcginness WJ, Telling RC. Vulvovaginitis in a child due to Shigella flexneri. Br Med J 1950;23:1424. [CrossRef]
4. 4. Davis TC. Chronic vulvovaginitis in children due to Shigella flexneri. Pediatrics 1975;56:41-4.
5. 5. Rajkumar S, Narayanaswamy G, Laude TA. Shigella vulvovaginitis in childhood: A case report. J Natl Med Assoc 1979;71:1005-6.
6. 6. Baiulescu M, Hannon PR, Marcinak JF, Janda WM, Schreckenberger PC. Chronic vulvovaginitis caused by antibiotic-resistant Shigella flexneri in a prepubertal child. Pediatr Infect Dis J 2002;21:170-2. [CrossRef]
7. 7. Namdari H, Taroli A, Piemontese S. Shigella flexneri as a cause of chronic vaginitis in an Allegedly Sexually Abused Five-Year-Old Girl. Clinical Microbiology Newsletter 2002;24:187-8. [CrossRef]
8. 8. Jasper JM, Ward MA. Shigella vulvovaginitis in a prepubertal child. Pediatr Emerg Care 2006;22:585-6. [CrossRef]

9. 9. Murphy TV, Nelson JD. Shigella vaginitis: report of 38 patients and review of the literature. Pediatrics 1979;63:511-6.
10. 10. Öner M, Özer B, Turan P, Şakru N. Dışkı kültürlerinde salmonella cinsi bakterilerin izolasyonunda uzamış inkübasyon süresinin etkisi. Trakya Univ Tıp Fak Derg 2005;22:23-6.
11. 11. Macsween KF, Ridgway GL. The laboratory investigation of vaginal discharge. J Clin Pathol 1998;51:564-7.
12. 12. Stricker T, Navratil F, Sennhauser F H. Vulvovaginitis in prepubertal girls. Arch Dis Child 2003;88:324-6. [CrossRef]
13. 13. Niyogi SK. Shigellosis. J Microbiol 2005;43:133-43. [Review] [CrossRef]
14. 14. Khan WA, Seas C, Dhar U, Salam MA, Bennish ML. Treatment of shigellosis: V. Comparison of azithromycin and ciprofloxacin. A double-blind, randomized, controlled trial. Ann Intern Med 1997;126:697-703.
15. 15. Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing; eighteenth informational supplement. CLSI document M100-S18. Wayne, PA: Clinical and Laboratory Standards Institute; 2008.