Adult nondiarrhea hemolytic uremic syndrome associated with Shiga toxin Escherichia coli O157:H7 bacteremia and urinary tract infection.

About 15% of children with Shiga toxin (Stx) producing Escherichia coli (STEC) primarily of serotype O157:H7, gastrointestinal infection, and watery or bloody diarrhea, may develop hemolytic uremic syndrome (D+ HUS). Usually D+ HUS is not complicated by bacteremia and patients recover spontaneously without antibiotic treatment. We report here an adult case of a STEC O157:H7 urinary tract infection complicated by bacteremia and HUS that was not preceded by diarrhea (D- HUS). Cases of D- HUS need to be carefully examined for foci other than the gastrointestinal tract, and patients with E coli bacteremia should receive early antibiotic treatment as would any patient with sepsis.

[1]  C. Wilcox,et al.  Therapy in Nephrology and Hypertension , 2003 .

[2]  A. King.  Acute inflammation in the pathogenesis of hemolytic-uremic syndrome. , 2002, Kidney international.

[3]  M. Oneko,et al.  Post-dysenteric hemolytic uremic syndrome in Bulawayo, Zimbabwe , 2001, Pediatric Nephrology.

[4]  M. Hogan,et al.  Two cases of non-O157:H7 Escherichia coli hemolytic uremic syndrome caused by urinary tract infection. , 2001, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[5]  G. Remuzzi,et al.  Thrombotic microangiopathy, hemolytic uremic syndrome and thrombotic thrombocytopenic purpura: Rare manifestations of Russell’s viper (Daboia russelii) envenoming in Sri Lanka , 2021 .

[6]  G. Remuzzi,et al.  Thrombotic microangiopathies in the intensive care unit: many questions, some answers. , 2001, Contributions to nephrology.

[7]  J. Bissler,et al.  Hemolytic uremic syndrome in an adolescent with Fusobacterium necrophorum bacteremia. , 2001, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[8]  T. Aragón,et al.  Risk of the hemolytic-uremic syndrome after antibiotic treatment of Escherichia coli O157:H7 infections. , 2000, The New England journal of medicine.

[9]  A. Kater,et al.  Toxin‐mediated haemolytic uraemic syndrome without diarrhoea , 2000, Journal of internal medicine.

[10]  F. Scheutz,et al.  Two cases of human urinary tract infection complicated by hemolytic uremic syndrome caused by verotoxin-producing Escherichia coli. , 2000, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[11]  Craig S. Wong,et al.  The risk of the hemolytic-uremic syndrome after antibiotic treatment of Escherichia coli O157:H7 infections. , 2000, The New England journal of medicine.

[12]  F. Grimont,et al.  Shiga toxin-producing Escherichia coli urinary tract infection associated with hemolytic-uremic syndrome in an adult and possible adverse effect of ofloxacin therapy. , 2000, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[13]  T. D. de Koning-Ward,et al.  Hemolytic-uremic syndrome following urinary tract infection with enterohemorrhagic Escherichia coli: case report and review. , 1998, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[14]  N. Rollins,et al.  Post-dysenteric hemolytic uremic syndrome in children during an epidemic of Shigella dysentery in Kwazulu/Natal , 1997, Pediatric Nephrology.

[15]  A. Stapleton,et al.  Hemolytic-uremic syndrome in a six-year-old girl after a urinary tract infection with Shiga-toxin-producing Escherichia coli O103:H2. , 1996, The New England journal of medicine.

[16]  Francesc Botet,et al.  Neonatal Hemolytic-Uremic Syndrome , 1995, Clinical pediatrics.

[17]  H. Lior,et al.  Haemolytic-uraemic syndrome , 1994, The Lancet.

[18]  C. Lingwood,et al.  Shiga toxin-associated hemolytic uremic syndrome: interleukin-1 beta enhancement of Shiga toxin cytotoxicity toward human vascular endothelial cells in vitro , 1993, Infection and immunity.

[19]  K. Forsyth,et al.  NEUTROPHIL-MEDIATED ENDOTHELIAL INJURY IN HAEMOLYTIC URAEMIC SYNDROME , 1989, The Lancet.

[20]  C. Krishnan,et al.  Laboratory investigation of outbreak of hemorrhagic colitis caused by Escherichia coli O157:H7 , 1987, Journal of clinical microbiology.