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Bonnie R Rachman
Am J Case Rep 2010; 11:87-89
Background: Shigellosis is a common pediatric disease that is rarely associated with shock. There are less than five cases reported in the English language literature. Folk medicine is a common practice throughout the world. Herbal remedies are viewed as natural and safe while pills may be viewed as dangerous.
For many herbal remedies, very little information exists on dosing, systemic toxicity and drug safety.
Case Report: We report a case of shigellosis and shock in a previously healthy 7-year-old Hispanic female. Ruta graveolens had either been ingested or placed in her rectum but this was not reported to the physicians responsible for her care. It was not recognized until a stool containing the plant material was passed after admission to the Pediatric Intensive Care Unit. Her shock was treated with fluid resuscitation, vasoactive medications and antibiotics. The shock resolved and she was transferred out of the Pediatric Intensive Care Unit on the third hospital day.
Conclusions: Folk remedies may complicate the natural course of a disease. Parents may not disclose the use of such a remedy spontaneously and many physicians do not inquire about their use. This case highlights the importance of taking a complete history including the use of herbal or other folk medications.