Hemolytic uremic syndrome due to Escherichia coli O157: H7 in a child with multiple infections.
Hemolytic uremic syndrome (HUS) is characterized by hemolytic anemia, thrombocytopenia, and uremia; it is a common cause of acute renal failure in children. Although many microbial agents have been associated with HUS, only Escherichia coli O157: H7 has been clearly demonstrated to be a major cause of this illness. A case is presented of a healthy 4-year-old boy who had a recent varicella infection; when evaluated for HUS his blood and stool cultures both grew Salmonella montevideo and blood cultures grew group A beta-hemolytic streptococci. A stool cultured on MacConkey-sorbitol agar also grew E. coli O157: H7. An eightfold rise in serum antibodies to E. coli O157: H7 lipopolysaccharide was also demonstrated. The child recovered completely and was healthy 3 years later. Although this child had several infectious agents anecdotally associated with HUS, appropriate culture of stool showed that he also had E. coli O157: H7 infection. Previous cases thought to be due to other pathogens may similarly have been caused by co-infection with E. coli O157: H7.
Ornt
D B
DB
Department of Medicine, University of Rochester, New York 14642.
Griffin
P M
PM
Wells
J G
JG
Powell
K R
KR
D000907:Antibodies, Bacterial / Q000032:analysis; D002675:Child, Preschool; D004926:Escherichia coli / Q000302:isolation & purification / Q000502:physiology*; D004927:Escherichia coli Infections / Q000097:blood / Q000150:complications*; D005243:Feces / Q000382:microbiology; D006463:Hemolytic-Uremic Syndrome / Q000097:blood / Q000209:etiology*; D006801:Humans; D008297:Male; D012475:Salmonella / Q000302:isolation & purification
D000907:Antibodies, Bacterial