Journal Article

Hemolytic-Uremic Syndrome Following Urinary Tract Infection with Enterohemorrhagic <i>Escherichia coli</i> : Case Report and Review

M. Starr, V. Bennett Wood, A. K. Bigham, T. F. de Koning Ward, A. M. Bordun, D. Lightfoot, K. A. Bettelheim, C. L. Jones and R. M. Robins Browne

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 2, pages 310-315
Published in print August 1998 | ISSN: 1058-4838
Published online August 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514656
Hemolytic-Uremic Syndrome Following Urinary Tract Infection with Enterohemorrhagic Escherichia coli : Case Report and Review

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A 6-week-old child with acute urinary tract infection caused by Shiga toxin—producing Escherichia coli (STEC) O5:H—developed hemolytic-uremic syndrome (HUS). Molecular and phenotypic analysis of the urinary isolate indicated that it lacked uropathic properties and that it was probably of intestinal origin. Nevertheless, the patient did not experience a diarrheal prodrome, nor was STEC or Shiga toxin detected in his feces at any time. Examination of the patient's serum pointed to recent infection with E. coli O5, with no evidence of exposure to E. coli O157, O111, or O26. A review of 13 previously reported cases of HUS associated with acute urinary tract infection indicated that this was the first case of nondiarrheal HUS in which infection with the most common STEC serogroups was specifically excluded. This case illustrates the need to investigate patients with nondiarrheal HUS for infection with STEC.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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