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 journalArticlepeer-review

21 Scopus citations

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)
Pages (from-to)e22.1-e22.6
JournalAmerican Journal of Kidney Diseases
Volume38
Issue number4 SUPPL. 3
DOIs
StatePublished - Oct 2001

Keywords

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

ASJC Scopus subject areas

  • Nephrology

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