Two Cases of Non-O157: H7 Escherichia coli Hemolytic Uremic Syndrome Caused by Urinary Tract Infection

Marie C Hogan, James M. Gloor, James R. Uhl, Franklin R. Cockerill, Dawn S. Milliner

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

• Escherichia coli serotype O157:H7 is a leading cause of diarrhea and hemolytic uremic syndrome (HUS). Because of the limitations of current diagnostic techniques, the prevalence of non-O157:H7 Shiga toxin-producing E coli strains is not known. We describe two patients with HUS in whom no E coli O157:H7 was demonstrable in stool cultures. On culture of the urine, the first patient was found to have E coli O113:H21 strain, and the second patient had E coli O6:H1 serotype. Shiga toxin production (stx2) by the O113:H21 isolate was confirmed. The first patient required 15 days of peritoneal dialysis and subsequently recovered renal function. At last follow-up, serum creatinine was 0.9 mg/dL. The second patient had preservation of renal function throughout the acute illness with serum creatinine of 0.5 mg/dL. The clinical presentation, bacteriology, course, and outcome as well as epidemiologic implications of the increasing number of patients with E coli urinary tract infections associated with HUS are discussed. These cases illustrate the need to investigate patients with nondiarrheal HUS for infection with Shiga toxin-producing E coli of the non-O157 strain variety.

Original languageEnglish (US)
JournalAmerican Journal of Kidney Diseases
Volume38
Issue number4 SUPPL. 3
DOIs
StatePublished - Oct 2001

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Hemolytic-Uremic Syndrome
Urinary Tract Infections
Escherichia coli
Shiga Toxin
Escherichia coli O157
Creatinine
Kidney
Bacteriology
Peritoneal Dialysis
Serum
Diarrhea
Urine
Infection

Keywords

  • End-stage renal disease
  • Enterohemorrhagic escherichia coli
  • Hemolytic uremic syndrome (hus)
  • Renal failure
  • Shiga toxins
  • Urinary tract infection

ASJC Scopus subject areas

  • Nephrology

Cite this

Two Cases of Non-O157 : H7 Escherichia coli Hemolytic Uremic Syndrome Caused by Urinary Tract Infection. / Hogan, Marie C; Gloor, James M.; Uhl, James R.; Cockerill, Franklin R.; Milliner, Dawn S.

In: American Journal of Kidney Diseases, Vol. 38, No. 4 SUPPL. 3, 10.2001.

Research output: Contribution to journalArticle

Hogan, Marie C ; Gloor, James M. ; Uhl, James R. ; Cockerill, Franklin R. ; Milliner, Dawn S. / Two Cases of Non-O157 : H7 Escherichia coli Hemolytic Uremic Syndrome Caused by Urinary Tract Infection. In: American Journal of Kidney Diseases. 2001 ; Vol. 38, No. 4 SUPPL. 3.
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