"Children on the frontline against E. coli": typical hemolytic-uremic syndrome.
A thirteen-month old infant presented with classical hemolytic-uremic syndrome (HUS), but with negative cultures for Escherichia coli (E. coli) 0157:H7. HUS is commonly linked to infection with E. coli 0157:H7; however, traditional culture has demonstrated poor sensitivity. Pathogenesis of the organism in HUS involves the production of a Shiga-like toxin (STX), resulting in a triad of symptoms. An early and accurate differential diagnosis, based on patient presentation with acute renal failure, hemolytic anemia, and thrombocytopenia, is critical for supportive treatment and improved prognosis. Patient prognosis is related to the duration of renal failure and dialysis treatment. Research is aimed at improved detection of E. coli 0157:H7 or the STX produced, and future vaccination to eliminate typical HUS.
Andersen
Heidi
H
St. Johns Hospital, Indianapolis, IN, USA. handerse@iupui.edu
D003937:Diagnosis, Differential; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis; D004926:Escherichia coli / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000150:complications / Q000473:pathology*; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000382:microbiology / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D011697:Purpura, Thrombotic Thrombocytopenic / Q000175:diagnosis; D051437:Renal Insufficiency / Q000209:etiology / Q000473:pathology