title: Hemolytic-uremic syndrome with acute encephalopathy in a pregnant woman infected with epidemic enterohemorrhagic Escherichia coli: characteristic brain images and cytokine profiles.
abstract: A food-poisoning outbreak due to enterohemorrhagic Escherichia coli (EHEC) occurred in Toyama, Japan. The case of a 26-year-old pregnant woman with hemolytic-uremic syndrome who developed acute encephalopathy due to EHEC infection after eating raw meat is presented herein. On day 2 following admission, a cesarean section was performed because of a non-reassuring fetal status. Fecal bacterial culture confirmed an O111/O157 superinfection. Intensive care therapies including continuous hemodiafiltration and plasma exchange were performed. After the operation, the patient developed encephalopathy for which steroid pulse therapy was added. Her condition improved gradually and she was discharged 55 days after delivery.
authors.affiliation: Department of Obstetrics and Gynecology, University of Toyama, Toyama-shi, Toyama 930-0194, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ito
authors.affiliation: Department of Obstetrics and Gynecology, University of Toyama, Toyama-shi, Toyama 930-0194, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Shiozaki
authors.affiliation: Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Shimizu
authors.affiliation: Department of Obstetrics and Gynecology, University of Toyama, Toyama-shi, Toyama 930-0194, Japan. Electronic address: s30saito@med.u-toyama.ac.jp.
authors.forename: S
authors.initials: S
authors.lastname: Saito
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D001927:Brain Diseases / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D016207:Cytokines / Q000097:blood; D054324:Enterohemorrhagic Escherichia coli / Q000302:isolation & purification*; D058872:Epidemics; D005243:Feces / Q000382:microbiology; D005260:Female; D005517:Foodborne Diseases / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D017583:Hemodiafiltration; D006463:Hemolytic-Uremic Syndrome / Q000150:complications* / Q000628:therapy; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008460:Meat / Q000382:microbiology; D059906:Neuroimaging; D010951:Plasma Exchange; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D016207:Cytokines
keywords: Encephalopathy; Enterohemorrhagic Escherichia coli; Hemolytic-uremic syndrome; Pregnacy