, Volume 6, Issue 3, pp 270-272

Hemolytic uremic syndrome due to Escherichia coli 0157: H7 in a child with multiple infections

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Hemolytic uremic syndrome (HUS) is characterized by hemolytic anemia, thrombocytopenia, and uremia; it is a common cause of acute renal failure in children. Although many microbial agents have been associated with HUS, onlyEscherichia coli 0157∶H7 has been clearly demonstrated to be a major cause of this illness. A case is presented of a healthy 4-year-old boy who had a recent varicella infection; when evaluated for HUS his blood and stool cultures both grewSalmonella montevideo and blood cultures grew group A β-hemolytic streptococci. A stool cultured on MacConkey-sorbitol agar also grewE. coli 0157∶H7. An eightfold rise in serum antibodies toE. coli 0157∶H7 lipopolysachcaride was also demonstrated. The child recovered completely and was healthy 3 years later. Although this child had several infectious agents anecdotally associated with HUS, appropriate culture of stool showed that he also hadE. coli 0157∶H7 infection. Previous cases though to be due to other pathogens may similarly have been caused by co-infection withE. coli 0157∶H7.

This manuscript has been published in abstract form; (1991) J Am Soc Nephrol 2:310