AIDS Presenting as Shigella colitis and Pneumocystis jiroveci Pneumonia in a FortyThree Years Old Male

Background: About 500,000 people are annually infected with Shigella species in the United States, with an average annual incidence of 4.82 cases per 100,000 individuals. While most reported cases have previously been described in children under the age of 10, Shigellosis has now been recognized as a sexually transmitted disease among men who have sex with men, with direct oral-anal contact posing as major risk factor. Methodology: In this abstract we describe a rare case presentation of sepsis due to Shigella colitis in a previously healthy individual that led to a new diagnosis of HIV/AIDS. What makes this case unique is that the patient's hospital course was soon complicated by hypoxic respiratory failure and recurrent sepsis associated with bilateral Pneumocystis jiroveci pneumonia confirmed with bronchoalveolar lavage. Results: With appropriate antibiotic therapy and supportive measures the patient made a remarkable recovery leading to discharge at a rehabilitation facility. In addition, the patient was followed at an HIV clinic and within six weeks of anti-retroviral treatment, his viral load decreased by three logs and he had an appropriate immunologic response. Conclusion:Shigellosis is a sexually transmitted disease that is prevalent in men who have sex with men, requiring a high index of suspicion in those who engage in oral-anal contact. To the best of our knowledge, this is the first case describing a previously healthy patient presenting with both Shigella and Pneumocystis jiroveci pneumonia, leading to a diagnosis of AIDS.