title: Adult hemolytic-uremic syndrome associated with urosepsis due to Shigatoxin-producing Escherichia coli O138:H-.
abstract: We report the case of a 62-year-old man without prodromal symptoms who developed a hemolytic-uremic syndrome (HUS) one week after the diagnosis of an acute bacteremic urinary infection (UTI). In this patient, the E. coli isolated in blood cultures was a non-O157:H7 Shigatoxin-producing strain that could subsequently be identified as O138:H-. This is a strain that is normally found in pigs and that has never been isolated in humans previously. UTI-related HUS is a rare event, as until now, only 14 pediatric and 3 adult cases have been reported. Indeed, this new case, besides its interesting microbiological aspects, should heighten our awareness of UTI-related HUS as a rare but real condition, not only in young children but also in adult patients. This should emphasize the necessity to search actively for other sources of Shigatoxin-producing E. coli in patients presenting with HUS without gastrointestinal symptoms.
authors.affiliation: Department of Internal Medicine, Cantonal Hospital, Fribourg, Switzerland.
authors.forename: Quan-Vinh
authors.initials: QV
authors.lastname: Nguyen
authors.forename: Lucile
authors.initials: L
authors.lastname: Hochstrasser
authors.forename: Christian
authors.initials: C
authors.lastname: Chuard
authors.forename: Herbert
authors.initials: H
authors.lastname: Hächler
authors.forename: Claude
authors.initials: C
authors.lastname: Regamey
authors.forename: Eric
authors.initials: E
authors.lastname: Descombes
mesh_terms: D000818:Animals; D004926:Escherichia coli / Q000302:isolation & purification / Q000378:metabolism*; D004927:Escherichia coli Infections / Q000382:microbiology*; D006463:Hemolytic-Uremic Syndrome / Q000150:complications / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D022621:Shiga Toxin / Q000096:biosynthesis*; D034421:Sus scrofa / Q000382:microbiology; D014552:Urinary Tract Infections / Q000382:microbiology*
chemical_list: D022621:Shiga Toxin