Shigella sonnei septicaemia in a neonate.

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Shigella sonnei septicaemia is a rare condition at any age and especially so in the newborn.Two neonatal cases have been reported from America (Whitfield and Humphries, 1967, Kraybill and Controni, 1968) but since there is no record of its occurrence in Great Britain a fatal infection at or immediately after birth is reported. Case ReportAfter an uneventful pregnancy a woman of 24 years was delivered of a normal 61b 3oz (2,807g) female infant.The baby's condition remained satisfactory for the first 22 hours, then respiratory distress developed followed by gastroenteritis three hours later.Intensive therapy was carried out including the giving of intravenous antibiotics.Transient improvement occurred but the infant died 69 hours after birth.Initially the mother mentioned a bout of diarrhoea lasting for a week three weeks before delivery.She attributed it to her iron tablets.On further questioning she added that scveral of her neighbours were also affected.Twenty-five hours after birth and before starting treatment culture of the baby's blood and stools yielded Shigella sonnei.After death this organism was cultured from the jejunum, ileum, colon, and anus as well as from the spleen and one lung.Though cultured several limes the mother's stools were positive only once, whereas a 3- year-old sister gave repeated positive cultures for over a fort- night.Stool cultures from the other two inmates of the house, the father and grandmother, were negative.No other cases were noti- fied to the Health Department from the area, though it was felt that the mother's statement that other cases did occur may well have been true as Sonne dysentery is usually a short, mild illness.At necropsy five and a half hours after death the body weighed 2,640g and was moderately jaundiced.The umbilicus was dry and the cord had separated.