title: Recurrent Hemolytic and Uremic Syndrome Induced by Escherichia Coli.
abstract: A widespread belief is that typical hemolytic and uremic syndrome (HUS) does not recur. We report the case of a patient infected twice with raw milk taken from his own cow and containing a Shiga toxin-producing Escherichia coli O174:H21 that induced recurrent HUS causing severe renal and cerebral disorders. A genomic comparison of the human and bovine Shiga toxin-producing Escherichia coli O174:H21 isolates revealed that they were identical. Typical HUS may recur. Since milk from this animal was occasionally distributed locally, thereby posing a serious threat for the whole village, this particular cow was destroyed.
authors.affiliation: From the APHP, Hôpital Tenon (MC, RK, CR, ER, AH), Urgences Néphrologiques et Transplantation Rénale, Institut Pasteur (F-XW, MG), Unité des Bactéries Pathogènes Entériques, Centre National de Référence des E coli et Shigella, Paris, VetAgro Sup (EL, AG), Campus vétérinaire de Lyon, Laboratoire d'études des microorganismes alimentaires pathogènes (LMAP), Laboratoire National de Référence pour les E coli y compris les E coli producteurs de Shiga-toxines (LNR STEC), Marcy L'Etoile, Service d'Immunologie, Hôpital Européen Georges Pompidou (VF-B); and UPMC Sorbonne Université Paris 06 (ER, AH), Paris, France.
authors.forename: Morgane
authors.initials: M
authors.lastname: Commereuc
authors.forename: Francois-Xavier
authors.initials: FX
authors.lastname: Weill
authors.forename: Estelle
authors.initials: E
authors.lastname: Loukiadis
authors.forename: Malika
authors.initials: M
authors.lastname: Gouali
authors.forename: Audrey
authors.initials: A
authors.lastname: Gleizal
authors.forename: Raphaël
authors.initials: R
authors.lastname: Kormann
authors.forename: Christophe
authors.initials: C
authors.lastname: Ridel
authors.forename: Véronique
authors.initials: V
authors.lastname: Frémeaux-Bacchi
authors.forename: Eric
authors.initials: E
authors.lastname: Rondeau
authors.forename: Alexandre
authors.initials: A
authors.lastname: Hertig
mesh_terms: D000368:Aged; D000818:Animals; D001431:Bacteriological Techniques; D024901:Drug Resistance, Multiple, Bacterial; D006463:Hemolytic-Uremic Syndrome / Q000382:microbiology*; D006801:Humans; D008297:Male; D008892:Milk / Q000382:microbiology*; D016133:Polymerase Chain Reaction; D054323:Shiga-Toxigenic Escherichia coli