title: [Predictive indicators for progression to severe complications(hemolytic-uremic syndrome and encephalopathy) and their prevention in enterohemorrhagic Escherichia coli infection].
abstract: The treatment of infection with enterohemorrhagic Escherichia coli(EHEC) aims for early prediction and prevention of severe complications such as hemolytic-uremic syndrome, encephalopathy and/or thrombotic thrombocytopenic purpura. Factors related to the complications are divided into three categories; risk factors or predisposition, predictors, and indicators of severity and outcome. Risk factors for complications include two extreme ages, infection with verotoxin 2 producing E. coli, positive stool culture for EHEC, use of antimotility drug, use of trimethoprim-sulfamethoxazole. Predictors for complications include severe abdominal pain and bloody diarrhea development of high fever, change of consciousness, urinal protein and/or occult blood, abrupt increase of white blood cell count, urinal NAG, alpha 1 microglobulin, beta 2 microglobulin, low osmolar urine, high thrombomodulin level, marked thickening of intestinal wall, increased brightness of kidney in ultrasound sonography. No preventive treatment for these complications is proven except SYNSORB-pk which is expected to effectively aborb verotoxin in the intestine.
authors.affiliation: Saitama Children's Medical Center, Division of Infectious Diseases and Clinical Immunology.
authors.forename: K
authors.initials: K
authors.lastname: Joh
mesh_terms: D001427:Bacterial Toxins; D001927:Brain Diseases / Q000209:etiology* / Q000517:prevention & control; D018450:Disease Progression; D004927:Escherichia coli Infections / Q000150:complications*; D019453:Escherichia coli O157; D005544:Forecasting; D006463:Hemolytic-Uremic Syndrome / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D009844:Oligosaccharides / Q000627:therapeutic use; D011697:Purpura, Thrombotic Thrombocytopenic / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors; D022641:Shiga Toxin 2; D012822:Silicon Dioxide; D018180:Thrombomodulin
chemical_list: D001427:Bacterial Toxins; D009844:Oligosaccharides; D022641:Shiga Toxin 2; D018180:Thrombomodulin; D012822:Silicon Dioxide