title: Adult nondiarrhea hemolytic uremic syndrome associated with Shiga toxin Escherichia coli O157:H7 bacteremia and urinary tract infection.
abstract: About 15% of children with Shiga toxin (Stx) producing Escherichia coli (STEC) primarily of serotype O157:H7, gastrointestinal infection, and watery or bloody diarrhea, may develop hemolytic uremic syndrome (D+ HUS). Usually D+ HUS is not complicated by bacteremia and patients recover spontaneously without antibiotic treatment. We report here an adult case of a STEC O157:H7 urinary tract infection complicated by bacteremia and HUS that was not preceded by diarrhea (D- HUS). Cases of D- HUS need to be carefully examined for foci other than the gastrointestinal tract, and patients with E coli bacteremia should receive early antibiotic treatment as would any patient with sepsis.
authors.affiliation: Clinical Research Center for Rare Diseases Aldo e Cele Daccò, Mario Negri Institute for Pharmacological Research, Villa Camozzi-Ranica, Bergamo, Italy. manuelap@marionegri.it
authors.forename: Carlos
authors.initials: C
authors.lastname: Chiurchiu
authors.forename: Anna
authors.initials: A
authors.lastname: Firrincieli
authors.forename: Marisa
authors.initials: M
authors.lastname: Santostefano
authors.forename: Maurizio
authors.initials: M
authors.lastname: Fusaroli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Remuzzi
authors.forename: Piero
authors.initials: P
authors.lastname: Ruggenenti
mesh_terms: D000328:Adult; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D003967:Diarrhea / Q000175:diagnosis / Q000382:microbiology*; D004359:Drug Therapy, Combination; D004927:Escherichia coli Infections / Q000097:blood / Q000188:drug therapy / Q000382:microbiology; D019453:Escherichia coli O157 / Q000187:drug effects / Q000302:isolation & purification* / Q000378:metabolism*; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D022621:Shiga Toxin / Q000096:biosynthesis*; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
chemical_list: D022621:Shiga Toxin