Cardiac Complications in Children with Shigella Encephalopathy

Shigella infections pose a serious health threat globally, particularly affecting children in low- and middle-income countries, leading to significant illness and death. Among the complications, encephalopathy is the most common, with recent studies indicating high mortality rates. While cardiac issues related to shigellosis have been documented in a single pediatric case, this study aimed to explore cardiac manifestations in children with shigella encephalopathy.

The current study followed children admitted to the Pediatric Intensive Care Unit (PICU) with shigella encephalopathy from June 2021 to May 2024. Children exhibiting loose stools and altered mental status or seizures underwent stool culture or PCR testing. Those whose condition improved with shock treatment or had pre-existing cardiac issues were excluded. All patients underwent electrocardiograms (ECGs) and echocardiograms, with cardiac troponin I and N-terminal pro-brain natriuretic peptide tests conducted if abnormalities were found. Treatment included ceftriaxone, along with standard protocols for managing seizures, elevated intracranial pressure, and shock.

The outcome revealed:

Out of 38 diagnosed cases (median age 6 years), 95% tested positive for Shigella spp.
Shock was present in 53% of the children, with 74% showing cardiac involvement.
Notably, a 10-year-old girl with hypotensive shock and tachycardia unfortunately did not survive.
The study found that shock significantly increased the risk of cardiac events.

Overall, these results indicate that cardiac complications are prevalent and can be severe in children with shigella encephalopathy, suggesting the need for routine cardiac evaluations in these patients.

Source: Jayakrishnan MP, Geeta MG, Shameem AM, et al. Cardiac Complications Associated with Shigella Encephalopathy in Children. Indian J Pediatr. 2025. https://doi.org/10.1007/s12098-025-05512-y

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