[Hemorrhagic colitis and hemolytic uremic syndrome caused by Escherichia coli O157:H7].
We report the case of an Escherichia coli O157:H7 infection in a patient with hemorrhagic colitis. Initial diagnosis was ischemic colitis because of the age of the patient and clinical presentation. After one week, a hemolytic-uremic syndrome occurred and serologic antibodies to the lipopolysaccharide O157 of Escherichia coli O157:H7 were positive, leading to the diagnosis of hemorrhagic colitis caused by this bacteria. Escherichia coli O157:H7 colonic infection is not well known, specially in France where only two cases has been reported in adults. This bacteria and the toxin produced (Shiga-like toxin) should be searched in cultures of stools and colonic biopsies in case of bloody diarrhea, in particular when a hemolytic-uremic syndrome is associated. As clinical, pathological and endoscopic findings in Escherichia coli O157:H7-associated colitis may be similar to the ischemic colitis pattern, differential diagnosis may be difficult.
Attar
A
A
Service d'Hépato-Gastroentérologie, Hôpital Broussais, Paris.
Becheur
H
H
Gilbert
T
T
Bloch
F
F
Petite
J P
JP
D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000473:pathology; D003937:Diagnosis, Differential; D004927:Escherichia coli Infections / Q000473:pathology*; D019453:Escherichia coli O157; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000473:pathology*; D006463:Hemolytic-Uremic Syndrome / Q000473:pathology*; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology