Shigella Bacteremia in Adults

To the Editor.— Shigella flexneriis a common cause of intestinal infections in homosexual men.1It often presents as a febrile illness associated with abdominal cramps and bloody diarrhea. Bacteremia that is infrequent most often complicates shigellosis in patients younger than 2 years and is considered rare in the adult population.2,3We report two cases of bacteremia withS flexneri:one in a patient with acquired immunodeficiency syndrome (AIDS) and the other in a homosexual man with severe hepatitis B. Report of Cases.— Case1.—A 25-year-old homosexual man with a history of glucose-6-phosphate dehydrogenase and asymptomatic sickle cell hemoglobin diseases and AIDS was admitted to the hospital with fever, abdominal cramps, and copious nonbloody diarrhea. Physical examination revealed a temperature of 39.5 °C (103.2 °F) orally, and diffuse abdominal tenderness. Laboratory findings included a white blood cell count of 8,300/cu mm with 35% neutrophils, 34% band forms, and