Atypical haemolytic uraemic syndrome presenting initially as suspected meningococcal disease: a case report.
BACKGROUND
Haemolytic uraemic syndrome (HUS) is the most common cause of acute renal failure in children and is usually linked with Escherichia coli O157 infection. With a fatality rate of around 5%, some reports have associated antibiotic treatment with a worsening prognosis.


METHODS
We describe a female infant patient, initially treated for suspected meningococcal septicaemia, who went on to develop renal complications and thrombocytopenia characteristic of HUS. A subsequent positive stool sample for E. coli O157 confirmed HUS as an appropriate diagnosis, although there was no evidence of diarrhoea or vomiting throughout the course of her management.


CONCLUSIONS
The urgency of early recognition and treatment for suspected meningococcal disease in very young children while entirely appropriate can initially divert attention from other serious conditions. Evidence of infection with E. coli O157 infection in this case also highlights what can be a blurred distinction between atypical (non-diarrhoeal) HUS from classical HUS of infective origin.
Sivamurthy
Siddharthan
S
Dorset and Somerset Health Protection Unit, Health Protection Agency South West Victoria House Ferndown, Dorset, BH22 9JR, UK. john.mooney@bp-pct.nhs.uk.
Mooney
John D
JD
Kenny
Tom D
TD