{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T16:30:17Z","timestamp":1793291417964,"version":"4.5.0"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003579","name":"University of Toronto","doi-asserted-by":"publisher","award":["Clinician Scientist Funding"],"award-info":[{"award-number":["Clinician Scientist Funding"]}],"id":[{"id":"10.13039\/501100003579","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009663","name":"University Health Network","doi-asserted-by":"publisher","award":["Clinician Scientist Funding"],"award-info":[{"award-number":["Clinician Scientist Funding"]}],"id":[{"id":"10.13039\/100009663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Infection"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>Both acute traveler\u2019s diarrhea and sexually transmitted infections are common causes of fever in the returned traveler, with the male sex corresponding to two-fold increased odds of a sexually transmitted infection (STI) diagnosis related to travel. Shigella flexneri is the most common cause of shigellosis in low- and middle-income countries, while within the men who have sex with men (MSM) population, outbreaks of S. flexneri 3a, S. flexneri 2a, and S. sonnei have been reported. We herein present a case of a febrile returned MSM traveler with a predominantly gastrointestinal presentation and proctocolitis whose microbiological work-up confirmed coinfection with S. flexneri and rectal gonorrhea. Based on his travel history and epidemiologic risk factors, it is unclear if food- and waterborne shigellosis versus transmission via sexual contact was the major route of acquisition. This case highlights the broad differential for proctocolitis and the importance of consideration of intercurrent infections.<\/jats:p>","DOI":"10.1177\/20499361251319659","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T08:27:51Z","timestamp":1739867271000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["A case of intercurrent shigellosis and rectal gonorrhea in an acutely unwell febrile returned traveler"],"prefix":"10.1177","volume":"12","author":[{"given":"Charlotte","family":"Fuller","sequence":"first","affiliation":[{"name":"Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruchika","family":"Bagga","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ezra","family":"Bado","sequence":"additional","affiliation":[{"name":"Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Zain","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada"},{"name":"SickKids Research Institute, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2720-6944","authenticated-orcid":false,"given":"Andrea K.","family":"Boggild","sequence":"additional","affiliation":[{"name":"Tropical Disease Unit, UHN-Toronto General Hospital, 200 Elizabeth Street, 13EN-218, Toronto, ON M5G2C4, Canada"},{"name":"Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada"},{"name":"Department of Medicine, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,2,18]]},"reference":[{"key":"bibr1-20499361251319659","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp0904162"},{"key":"bibr2-20499361251319659","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)33296-8"},{"key":"bibr3-20499361251319659","unstructured":"Garcia-Williams A, Esschert KV, Logan N. Shigellosis | CDC Yellow Book 2024. (n.d.), https:\/\/wwwnc.cdc.gov\/travel\/yellowbook\/2024\/infections-diseases\/shigellosis (2023, accessed 28 June 2024)."},{"key":"bibr4-20499361251319659","doi-asserted-by":"publisher","DOI":"10.3201\/eid0506.990614"},{"key":"bibr5-20499361251319659","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)00002-X"},{"key":"bibr6-20499361251319659","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-052962"},{"key":"bibr7-20499361251319659","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(22)00520-5"},{"key":"bibr8-20499361251319659","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.02337-21"},{"key":"bibr9-20499361251319659","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-019-0128-6"},{"key":"bibr10-20499361251319659","unstructured":"Canada, Public Health Agency. 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