[A case of hemolytic uremic syndrome caused by verotoxin producing enteropathogenic Escherichia coli (O157:H7) with prolonged cerebrovascular dysfunction].
A 56-year-old woman was admitted to our hospital because of bloody watery diarrhea. Stool cultures on admission revealed the verotoxin producing enteropathogenic Escherichia coli (VTEC) (O157:H7). Hemolytic uremic syndrome (HUS) appeared on the 4th hospital day. Plasma exchange was performed from the 4th day to the 11th day. Mental confusion appeared on the 6th day, and was aggravated until the 18th day, and slowly improved afterwards. Serial cranial CT in series demonstrated low density areas in the bilateral parietooccipital lobes on the 26th day, and the left one diminished but the right one became more evident on the 49th day. The series of single photon emission computed topography (SPECT) revealed that in the region of the temporoparietooccipital lobe cerebral blood flow decreased on the left side on the 30th day, on both sides on the 39th day, and on the right side on the 82nd day. There are few reports of prolonged cerebrovascular dysfunction observed in serial studies of SPECT in a patient of HUS by VTEC (O157:H7). We should be aware, however, of the appearance of the CNS involvement in the recovery stage because the prolonged cerebrovascular dysfunction may occur as our case.
Yaginuma
M
M
Department of Internal Medicine, Tokyo Metropolitan Bokutoh Hospital.
Sazaki
N
N
D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000209:etiology* / Q000503:physiopathology; D004927:Escherichia coli Infections / Q000150:complications*; D019453:Escherichia coli O157; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000150:complications*; D006801:Humans; D008875:Middle Aged