title: Fatal case of hemolytic-uremic syndrome in an adult due to a rare serogroup O91 Entero hemorrhagic Escherichia coli associated with a Clostridium difficile infection. More than meets the eye.
abstract: Hemolytic-uremic syndrome due to enterohemorrhagic Escherichia coli, belonging to serogroup O91 has rarely been described. We report here a case of post-diarrheal HUS due to EHEC O91 in an elderly patient for whom diagnosis was delayed given a previously diagnosed C. difficile infection. This case highlights the usefulness of Shiga-toxin detection.
authors.affiliation: CHU Reims, Hôpital Robert Debré, Laboratoire de Bactériologie-Virologie-Hygiène, 51092 Reims, France; UFR Médecine, SFR CAP-Santé, EA 4687, Université de Reims Champagne-Ardenne, 51092, Reims, France. Electronic address: tguillard@chu-reims.fr.
authors.forename: Thomas
authors.initials: T
authors.lastname: Guillard
authors.affiliation: CHU Reims, Hôpital Robert Debré, Laboratoire de Bactériologie-Virologie-Hygiène, 51092 Reims, France; UFR Médecine, SFR CAP-Santé, EA 4687, Université de Reims Champagne-Ardenne, 51092, Reims, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Limelette
authors.affiliation: CHU Reims, Hôpital Robert Debré, Laboratoire de Bactériologie-Virologie-Hygiène, 51092 Reims, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Le Magrex-Debar
authors.affiliation: CHU Reims, Hôpital Maison Blanche, Service de Néphrologie, 51092, Reims, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Wynckel
authors.affiliation: Centre National de Référence des Escherichia coli, Shigella et Salmonella (CNR ESS) Unité de Recherche et d'Expertise des Bactéries Pathogènes Entériques, Institut Pasteur, 75724 Paris, France.
authors.forename: Malika
authors.initials: M
authors.lastname: Gouali
authors.affiliation: Centre National de Référence associé des Escherichia coli, Hôpital Robert Debré, 75019 Paris, France.
authors.forename: Patricia
authors.initials: P
authors.lastname: Mariani-Kurkdjian
authors.affiliation: CHU Reims, Hôpital Maison Blanche, Service de Néphrologie, 51092, Reims, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Guyot-Colosio
authors.affiliation: CHU Reims, Hôpital Robert Debré, Laboratoire de Bactériologie-Virologie-Hygiène, 51092 Reims, France; UFR Médecine, SFR CAP-Santé, EA 4687, Université de Reims Champagne-Ardenne, 51092, Reims, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: de Champs
mesh_terms: D000368:Aged; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000150:complications*; D060085:Coinfection / Q000175:diagnosis / Q000382:microbiology*; D003967:Diarrhea / Q000382:microbiology; D054324:Enterohemorrhagic Escherichia coli / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000150:complications / Q000175:diagnosis / Q000382:microbiology*; D017809:Fatal Outcome; D006463:Hemolytic-Uremic Syndrome / Q000150:complications / Q000175:diagnosis / Q000382:microbiology*; D006801:Humans; D008297:Male; D065288:Serogroup
keywords: Clostridium difficile; Escherichia coli; Hemolytic Uremic Syndrome