Hemolytic uremic syndrome caused by E. coli O157 infection
A 7-year-old previously healthy boy presented with five days of low-grade fever, emesis, and bloody diarrhea. He was initially seen by his primary care physician where he was given a fluid bolus and was sent home. The patient returned to the hospital a few hours later because his symptoms had not improved and he had begun to feel lethargic. Upon admission he was noted to have persistent dehydration, hyponatremia, acute renal failure, leukocytosis with left shift, and an elevated C-reactive protein. The patient received a bolus of 5% dextrose in ½ normal saline. During his hospitalization the patient was noted to have multiple episodes of watery, bloody diarrhea as well as projectile emesis with dark black vomitus. No other family members were sick.
The patient was transferred from the community hospital to the pediatric intensive care unit of a tertiary care center for worsening hyponatremia and dehydration. The patient was neurologically intact (GCS 15) upon admission and...
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Conflict of interest
Authors PB, RB, and JP declare that they have no conflict of interest.
All procedures performed in studies/tests involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from the parent(s) for all medical procedures described in this report, with the exception of the autopsy, which was performed under the jurisdiction of the medical examiner’s office. The informed consent included permission for specimen testing and record review for teaching and research purposes.
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