TY - JOUR
T1 - Two Cases of Non-O157:H7 Escherichia coli Hemolytic Uremic Syndrome Caused by Urinary Tract Infection
AU - Hogan, Marie C.
AU - Gloor, James M.
AU - Uhl, James R.
AU - Cockerill, Franklin R.
AU - Milliner, Dawn S.
N1 - Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2001/10
Y1 - 2001/10
N2 - • 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.
AB - • 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.
KW - End-stage renal disease
KW - Enterohemorrhagic escherichia coli
KW - Hemolytic uremic syndrome (hus)
KW - Renal failure
KW - Shiga toxins
KW - Urinary tract infection
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U2 - 10.1053/ajkd.2001.27731
DO - 10.1053/ajkd.2001.27731
M3 - Article
C2 - 11576909
AN - SCOPUS:0346451324
SN - 0272-6386
VL - 38
SP - e22.1-e22.6
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 4 SUPPL. 3
ER -