Thus, increased cytokine elaboration may play a role in the pathogenesis of myonecrosis in shigellosis. An alternative mechanism for myonecrosis could involve the direct effects of toxins. This toxin is produced predominantly by S. dysenteriae. There is currently little evidence to implicate this toxin in the pathogenesis of systemic manifestations of S. sonnei infections. The occurrence of rhabdomyolysis as a direct complication of shigella infection is rare.
Available evidence precludes delineation of the underlying pathophysiological mechanism.
However, awareness of the possibility of myonecrosis in the setting of shigellosis mandates heightened clinical suspicion for the presence of this complication. In order to reduce the risk of acute renal failure, physicians should have a low threshold for screening for rhabdomyolysis in patients presenting with clinical features consistent with shigellosis. Rev Infect Dis. Clin Lab Med. Shigella enterocolitis and acute renal failure.