title: A case of severe hemorrhagic diarrhea.
abstract: A 50-year-old white female presented to the emergency department with diarrhea, abdominal pain, and hematochezia. The illness started four days prior to presentation and escalated to 10-15 bowel movements daily. She was tachycardic and hypotensive upon presentation with a diffusely tender abdomen. Her anemia and persistent hematochezia prompted endoscopy by a gastroenterologist. Flexible sigmoidoscopy was performed to the splenic flexure and revealed evidence of severe active colitis. The mucosa was friable and severely ulcerated. Numerous biopsies were obtained that revealed acute colitis with fibrinopurulent exudates. A stool culture showed Escherichia coli O157:H7, which was confirmed by the Mississippi State Board of Health. Infection with E. coli O157:H7 affects nearly 1.1 per 100,000 Americans annually. It accounts for about 3% of all bacterial and protozoal causes of foodborne illnesses and possesses a mortality rate of about 1-2%.
authors.affiliation: Department of Internal Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA. Ashleysumrall@bellsouth.net
authors.forename: Ashley
authors.initials: A
authors.lastname: Sumrall
authors.forename: Lindsey
authors.initials: L
authors.lastname: McMullan
authors.forename: Chris
authors.initials: C
authors.lastname: Abrasley
authors.forename: Honey
authors.initials: H
authors.lastname: East
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000382:microbiology; D003967:Diarrhea / Q000175:diagnosis* / Q000382:microbiology; D004927:Escherichia coli Infections / Q000175:diagnosis* / Q000382:microbiology; D019453:Escherichia coli O157; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000382:microbiology; D006801:Humans; D008875:Middle Aged