[The clinical course and laboratory data of hemorrhagic colitis caused by Escherichia coli O157:H7].
An outbreak of E. coli O157 infection occurred in July 1996 in Sakai City, apparently associated with school lunches. About 5000 children were infected and more than 600 were hospitalized. In our hospital, we treated 13 patients of hemorrhagic colitis(HC) including 4 hemolytic uremic syndrome(HUS) patients then. First, a typical patient developed HUS was presented. A case was 8 years' old girl. She was developed HUS on the 6th day after the onset of HC. We treated her with plasma exchange. She was recovered on the 14th day from HUS without any sequela. In this report, I discussed about pathophysiology of HUS according to her clinical course. Secondly, I reported that analysis of the clinical courses and laboratory data of 818 patients hospitalized from the questionnaires sent by Osaka Prefecture Medical Association. One One hundred twenty two patients developed HUS. Patients with HUS produced bloody stools longer than the others, on the average(6.7 vs. 3.4 day). Mean serum C-reactive protein levels was 4.8mg/dl in patients with HUS but 1.5mg/dl in the other patients; the WBC count also was higher in HUS(17,780 vs. 9,700mm3). The mean serum Na level was lower in patients of HUS. Almost all patients were given antibiotics. The incidence of HUS among patients treated with new quinolones was lower than that of all patients. On the contrary, the higher incidence among patients with cephalosporins was observed.
Kawamura
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Department of Pediatrics, Osaka City University Medical School.
D000293:Adolescent; D002648:Child; D003092:Colitis / Q000209:etiology*; D004196:Disease Outbreaks; D004927:Escherichia coli Infections; D019453:Escherichia coli O157; D005260:Female; D005517:Foodborne Diseases; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006463:Hemolytic-Uremic Syndrome / Q000209:etiology*; D006801:Humans; D008297:Male