title: Neuropsychological outcome after complicated Shiga toxin-producing Escherichia coli infection.
abstract: BACKGROUND
  The diarrhea associated hemolytic uremic syndrome (HUS) is a major cause of acute uremic failure in children, but not very common in adults. The enterohaemorrhagic Escherichia coli-epidemic in Germany in 2011 affected mostly young and healthy adults. While their immediate deficits have been published, not much is known about the time course and degree of recovery concerning cognitive and behavioral impairment.
  
  
  RESULTS
  Twenty patients with Shiga toxin-producing Escherichia coli infection and neurological symptoms underwent comprehensive neuropsychological assessment 3 months and 1 year after the acute disease. Overall, there was an excellent recovery of cognitive functions. In a detailed neuropsychological analysis no significant deficits could be noticed 1 year after the infection in terms of cognitive function, alertness, executive functions and speech. Interestingly there were no correlations between different indicators for severity of disease (hemoglobin and creatinine levels, days of hospitalization, neurological symptoms and MRI changes) and neuropsychological outcome. However, there were a small number of patients with limitations in every day and professional life even one year after the acute disease.
  
  
  CONCLUSIONS
  Our study does not provide definitive answers regarding risk factors for these limitations. Still since Shiga toxin -producing Escherichia coli infection is a rare condition in adults, the information this study provides is important for the clinical practice. On one hand for consulting patients and on the other to raise the awareness of the physicians to possible long term complains and the consideration of neuropsychological assessment and supportive psychological treatment.
authors: Department of Neurology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
authors: Olga
authors: O
authors: Simova
authors: Department of Neurology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
authors: Gabriele
authors: G
authors: Weineck
authors: Department of Neurology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
authors: Thorsten
authors: T
authors: Schuetze
authors: Institute of Biometrics, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
authors: Karl
authors: K
authors: Wegscheider
authors: Department of Internal Medicine III and Clinics, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
authors: Ulf
authors: U
authors: Panzer
authors: Department of Internal Medicine III and Clinics, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
authors: Rolf A K
authors: RA
authors: Stahl
authors: Department of Neurology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
authors: Christian
authors: C
authors: Gerloff
authors: Department of Neurology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
authors: Tim
authors: T
authors: Magnus
mesh_terms: D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000209:etiology* / Q000382:microbiology; D004196:Disease Outbreaks; D004927:Escherichia coli Infections / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D056344:Executive Function; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D064926:Neurophysiological Monitoring; D054323:Shiga-Toxigenic Escherichia coli / Q000302:isolation & purification*; D013060:Speech