Unusual severe case of hemolytic uremic syndrome due to Shiga toxin 2d-producing E. coli O80:H2
Background Hemolytic uremic syndrome (HUS) is one of the most common causes of acute renal failure in children, with the majority of cases caused by an infection with Shiga toxin-producing Escherichia coli (STEC). Whereas O157 is still the predominant STEC serotype, non-O157 serotypes are increasing...
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| Veröffentlicht in: | Pediatric nephrology (Berlin, West) West), 2017-07, Vol.32 (7), p.1263-1268 |
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| creator | Wijnsma, Kioa L. Schijvens, Anne M. Rossen, John W. A. Kooistra-Smid, A. M. D. (Mirjam) Schreuder, Michiel F. van de Kar, Nicole C. A. J. |
| description | Background
Hemolytic uremic syndrome (HUS) is one of the most common causes of acute renal failure in children, with the majority of cases caused by an infection with Shiga toxin-producing
Escherichia coli
(STEC). Whereas O157 is still the predominant STEC serotype, non-O157 serotypes are increasingly associated with STEC-HUS. However, little is known about this emerging and highly diverse group of non-O157 serotypes. With supportive therapy, STEC-HUS is often self-limiting, with occurrence of chronic sequelae in just a small proportion of patients.
Case diagnosis/treatment
In this case report, we describe a 16-month-old boy with a highly severe and atypical presentation of STEC-HUS. Despite the presentation with multi-organ failure and extensive involvement of central nervous system due to extensive thrombotic microangiopathy (suggestive of atypical HUS), fecal diagnostics revealed an infection with the rare serotype: shiga toxin 2d-producing STEC O80:H2.
Conclusions
This report underlines the importance of STEC diagnostic tests in all children with HUS, including those with an atypical presentation, and emphasizes the importance of molecular and serotyping assays to estimate the virulence of an STEC strain. |
| doi_str_mv | 10.1007/s00467-017-3642-3 |
| format | Article |
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Hemolytic uremic syndrome (HUS) is one of the most common causes of acute renal failure in children, with the majority of cases caused by an infection with Shiga toxin-producing
Escherichia coli
(STEC). Whereas O157 is still the predominant STEC serotype, non-O157 serotypes are increasingly associated with STEC-HUS. However, little is known about this emerging and highly diverse group of non-O157 serotypes. With supportive therapy, STEC-HUS is often self-limiting, with occurrence of chronic sequelae in just a small proportion of patients.
Case diagnosis/treatment
In this case report, we describe a 16-month-old boy with a highly severe and atypical presentation of STEC-HUS. Despite the presentation with multi-organ failure and extensive involvement of central nervous system due to extensive thrombotic microangiopathy (suggestive of atypical HUS), fecal diagnostics revealed an infection with the rare serotype: shiga toxin 2d-producing STEC O80:H2.
Conclusions
This report underlines the importance of STEC diagnostic tests in all children with HUS, including those with an atypical presentation, and emphasizes the importance of molecular and serotyping assays to estimate the virulence of an STEC strain.</description><identifier>ISSN: 0931-041X</identifier><identifier>EISSN: 1432-198X</identifier><identifier>DOI: 10.1007/s00467-017-3642-3</identifier><identifier>PMID: 28343354</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Analysis ; Anti-Bacterial Agents - therapeutic use ; Antibodies, Monoclonal, Humanized - therapeutic use ; Bacterial toxins ; Biopsy ; Blood Culture ; Brief Report ; Care and treatment ; Causes of ; Ceftriaxone - therapeutic use ; Central nervous system ; Children ; Complications ; Diagnosis ; Dosage and administration ; Escherichia coli ; Escherichia coli Infections - blood ; Escherichia coli Infections - complications ; Escherichia coli Infections - drug therapy ; Escherichia coli Infections - microbiology ; Hemolytic uremic syndrome ; Hemolytic-Uremic Syndrome - blood ; Hemolytic-Uremic Syndrome - complications ; Hemolytic-Uremic Syndrome - drug therapy ; Hemolytic-Uremic Syndrome - microbiology ; Humans ; Infant ; Kidneys ; Liver - pathology ; Magnetic Resonance Imaging ; Male ; Medicine ; Medicine & Public Health ; Midazolam - therapeutic use ; Multiple Organ Failure - blood ; Multiple Organ Failure - complications ; Multiple Organ Failure - drug therapy ; Multiple Organ Failure - microbiology ; Nephrology ; Pediatrics ; Real-Time Polymerase Chain Reaction ; Renal failure ; Resuscitation ; Serotypes ; Serotyping ; Serotyping - methods ; Shiga toxin ; Shiga Toxin 2 - isolation & purification ; Shiga Toxin 2 - toxicity ; Shiga-Toxigenic Escherichia coli - isolation & purification ; Shiga-Toxigenic Escherichia coli - metabolism ; Shiga-Toxigenic Escherichia coli - pathogenicity ; Thrombotic Microangiopathies - blood ; Thrombotic Microangiopathies - complications ; Thrombotic Microangiopathies - drug therapy ; Thrombotic Microangiopathies - microbiology ; Thrombotic microangiopathy ; Toxins ; Urology ; Virulence ; Virulence (Microbiology)</subject><ispartof>Pediatric nephrology (Berlin, West), 2017-07, Vol.32 (7), p.1263-1268</ispartof><rights>The Author(s) 2017</rights><rights>COPYRIGHT 2017 Springer</rights><rights>Pediatric Nephrology is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c606t-9191d5567ad9296128669ec10cffc55db4855e9aab1b7a783618dd82f20eaa523</citedby><cites>FETCH-LOGICAL-c606t-9191d5567ad9296128669ec10cffc55db4855e9aab1b7a783618dd82f20eaa523</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00467-017-3642-3$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00467-017-3642-3$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28343354$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wijnsma, Kioa L.</creatorcontrib><creatorcontrib>Schijvens, Anne M.</creatorcontrib><creatorcontrib>Rossen, John W. A.</creatorcontrib><creatorcontrib>Kooistra-Smid, A. M. D. (Mirjam)</creatorcontrib><creatorcontrib>Schreuder, Michiel F.</creatorcontrib><creatorcontrib>van de Kar, Nicole C. A. J.</creatorcontrib><title>Unusual severe case of hemolytic uremic syndrome due to Shiga toxin 2d-producing E. coli O80:H2</title><title>Pediatric nephrology (Berlin, West)</title><addtitle>Pediatr Nephrol</addtitle><addtitle>Pediatr Nephrol</addtitle><description>Background
Hemolytic uremic syndrome (HUS) is one of the most common causes of acute renal failure in children, with the majority of cases caused by an infection with Shiga toxin-producing
Escherichia coli
(STEC). Whereas O157 is still the predominant STEC serotype, non-O157 serotypes are increasingly associated with STEC-HUS. However, little is known about this emerging and highly diverse group of non-O157 serotypes. With supportive therapy, STEC-HUS is often self-limiting, with occurrence of chronic sequelae in just a small proportion of patients.
Case diagnosis/treatment
In this case report, we describe a 16-month-old boy with a highly severe and atypical presentation of STEC-HUS. Despite the presentation with multi-organ failure and extensive involvement of central nervous system due to extensive thrombotic microangiopathy (suggestive of atypical HUS), fecal diagnostics revealed an infection with the rare serotype: shiga toxin 2d-producing STEC O80:H2.
Conclusions
This report underlines the importance of STEC diagnostic tests in all children with HUS, including those with an atypical presentation, and emphasizes the importance of molecular and serotyping assays to estimate the virulence of an STEC strain.</description><subject>Analysis</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibodies, Monoclonal, Humanized - therapeutic use</subject><subject>Bacterial toxins</subject><subject>Biopsy</subject><subject>Blood Culture</subject><subject>Brief Report</subject><subject>Care and treatment</subject><subject>Causes of</subject><subject>Ceftriaxone - therapeutic use</subject><subject>Central nervous system</subject><subject>Children</subject><subject>Complications</subject><subject>Diagnosis</subject><subject>Dosage and administration</subject><subject>Escherichia coli</subject><subject>Escherichia coli Infections - blood</subject><subject>Escherichia coli Infections - complications</subject><subject>Escherichia coli Infections - drug therapy</subject><subject>Escherichia coli Infections - microbiology</subject><subject>Hemolytic uremic syndrome</subject><subject>Hemolytic-Uremic Syndrome - blood</subject><subject>Hemolytic-Uremic Syndrome - complications</subject><subject>Hemolytic-Uremic Syndrome - drug therapy</subject><subject>Hemolytic-Uremic Syndrome - microbiology</subject><subject>Humans</subject><subject>Infant</subject><subject>Kidneys</subject><subject>Liver - pathology</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Midazolam - therapeutic use</subject><subject>Multiple Organ Failure - blood</subject><subject>Multiple Organ Failure - complications</subject><subject>Multiple Organ Failure - drug therapy</subject><subject>Multiple Organ Failure - microbiology</subject><subject>Nephrology</subject><subject>Pediatrics</subject><subject>Real-Time Polymerase Chain Reaction</subject><subject>Renal failure</subject><subject>Resuscitation</subject><subject>Serotypes</subject><subject>Serotyping</subject><subject>Serotyping - methods</subject><subject>Shiga toxin</subject><subject>Shiga Toxin 2 - isolation & purification</subject><subject>Shiga Toxin 2 - toxicity</subject><subject>Shiga-Toxigenic Escherichia coli - isolation & purification</subject><subject>Shiga-Toxigenic Escherichia coli - metabolism</subject><subject>Shiga-Toxigenic Escherichia coli - pathogenicity</subject><subject>Thrombotic Microangiopathies - blood</subject><subject>Thrombotic Microangiopathies - complications</subject><subject>Thrombotic Microangiopathies - drug therapy</subject><subject>Thrombotic Microangiopathies - microbiology</subject><subject>Thrombotic microangiopathy</subject><subject>Toxins</subject><subject>Urology</subject><subject>Virulence</subject><subject>Virulence (Microbiology)</subject><issn>0931-041X</issn><issn>1432-198X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kl1rFDEYhYModl39Ad5IQPBu1nxMZjJeCKVUKxR6oYXehWzyzkzKTLImM6X7782yte7CSi4S8j7nJBwOQu8pWVFC6s-JkLKqC0LrglclK_gLtKAlZwVt5N1LtCANpwUp6d0ZepPSPSFEClm9RmdM8pJzUS6QuvVzmvWAEzxABGx0Ahxa3MMYhu3kDJ4jjHlLW29jGAHbGfAU8M_edTofHp3HzBabGOxsnO_w5QqbMDh8I8mXK_YWvWr1kODd075Et98uf11cFdc3339cnF8XpiLVVDS0oVaIqta2YU1FmayqBgwlpm2NEHZdSiGg0XpN17WuJa-otFaylhHQWjC-RF_3vpt5PYI14KeoB7WJbtRxq4J26njiXa-68KBEWRKR01iij08GMfyeIU3qPszR5z8r2hBKZVlx-Y_q9ADK-TZkMzO6ZNS5EJRwtuOWqDhBdeAhvxw8tC5fH_GrE3xedhf9ScGnA0EPepj6FIZ5csGnY5DuQRNDShHa50QoUbsOqX2HVO6Q2nVI8az5cBjls-JvaTLA9kDKI99BPIjqv65_AB_mzpA</recordid><startdate>20170701</startdate><enddate>20170701</enddate><creator>Wijnsma, Kioa L.</creator><creator>Schijvens, Anne M.</creator><creator>Rossen, John W. A.</creator><creator>Kooistra-Smid, A. M. D. (Mirjam)</creator><creator>Schreuder, Michiel F.</creator><creator>van de Kar, Nicole C. A. 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A. ; Kooistra-Smid, A. M. D. (Mirjam) ; Schreuder, Michiel F. ; van de Kar, Nicole C. A. J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c606t-9191d5567ad9296128669ec10cffc55db4855e9aab1b7a783618dd82f20eaa523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Analysis</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibodies, Monoclonal, Humanized - therapeutic use</topic><topic>Bacterial toxins</topic><topic>Biopsy</topic><topic>Blood Culture</topic><topic>Brief Report</topic><topic>Care and treatment</topic><topic>Causes of</topic><topic>Ceftriaxone - therapeutic use</topic><topic>Central nervous system</topic><topic>Children</topic><topic>Complications</topic><topic>Diagnosis</topic><topic>Dosage and administration</topic><topic>Escherichia coli</topic><topic>Escherichia coli Infections - blood</topic><topic>Escherichia coli Infections - complications</topic><topic>Escherichia coli Infections - drug therapy</topic><topic>Escherichia coli Infections - microbiology</topic><topic>Hemolytic uremic syndrome</topic><topic>Hemolytic-Uremic Syndrome - blood</topic><topic>Hemolytic-Uremic Syndrome - complications</topic><topic>Hemolytic-Uremic Syndrome - drug therapy</topic><topic>Hemolytic-Uremic Syndrome - microbiology</topic><topic>Humans</topic><topic>Infant</topic><topic>Kidneys</topic><topic>Liver - pathology</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Midazolam - therapeutic use</topic><topic>Multiple Organ Failure - blood</topic><topic>Multiple Organ Failure - complications</topic><topic>Multiple Organ Failure - drug therapy</topic><topic>Multiple Organ Failure - microbiology</topic><topic>Nephrology</topic><topic>Pediatrics</topic><topic>Real-Time Polymerase Chain Reaction</topic><topic>Renal failure</topic><topic>Resuscitation</topic><topic>Serotypes</topic><topic>Serotyping</topic><topic>Serotyping - methods</topic><topic>Shiga toxin</topic><topic>Shiga Toxin 2 - isolation & purification</topic><topic>Shiga Toxin 2 - toxicity</topic><topic>Shiga-Toxigenic Escherichia coli - isolation & purification</topic><topic>Shiga-Toxigenic Escherichia coli - metabolism</topic><topic>Shiga-Toxigenic Escherichia coli - pathogenicity</topic><topic>Thrombotic Microangiopathies - blood</topic><topic>Thrombotic Microangiopathies - complications</topic><topic>Thrombotic Microangiopathies - drug therapy</topic><topic>Thrombotic Microangiopathies - microbiology</topic><topic>Thrombotic microangiopathy</topic><topic>Toxins</topic><topic>Urology</topic><topic>Virulence</topic><topic>Virulence (Microbiology)</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wijnsma, Kioa L.</creatorcontrib><creatorcontrib>Schijvens, Anne M.</creatorcontrib><creatorcontrib>Rossen, John W. A.</creatorcontrib><creatorcontrib>Kooistra-Smid, A. M. D. (Mirjam)</creatorcontrib><creatorcontrib>Schreuder, Michiel F.</creatorcontrib><creatorcontrib>van de Kar, Nicole C. A. J.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatric nephrology (Berlin, West)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wijnsma, Kioa L.</au><au>Schijvens, Anne M.</au><au>Rossen, John W. A.</au><au>Kooistra-Smid, A. M. D. (Mirjam)</au><au>Schreuder, Michiel F.</au><au>van de Kar, Nicole C. A. J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Unusual severe case of hemolytic uremic syndrome due to Shiga toxin 2d-producing E. coli O80:H2</atitle><jtitle>Pediatric nephrology (Berlin, West)</jtitle><stitle>Pediatr Nephrol</stitle><addtitle>Pediatr Nephrol</addtitle><date>2017-07-01</date><risdate>2017</risdate><volume>32</volume><issue>7</issue><spage>1263</spage><epage>1268</epage><pages>1263-1268</pages><issn>0931-041X</issn><eissn>1432-198X</eissn><abstract>Background
Hemolytic uremic syndrome (HUS) is one of the most common causes of acute renal failure in children, with the majority of cases caused by an infection with Shiga toxin-producing
Escherichia coli
(STEC). Whereas O157 is still the predominant STEC serotype, non-O157 serotypes are increasingly associated with STEC-HUS. However, little is known about this emerging and highly diverse group of non-O157 serotypes. With supportive therapy, STEC-HUS is often self-limiting, with occurrence of chronic sequelae in just a small proportion of patients.
Case diagnosis/treatment
In this case report, we describe a 16-month-old boy with a highly severe and atypical presentation of STEC-HUS. Despite the presentation with multi-organ failure and extensive involvement of central nervous system due to extensive thrombotic microangiopathy (suggestive of atypical HUS), fecal diagnostics revealed an infection with the rare serotype: shiga toxin 2d-producing STEC O80:H2.
Conclusions
This report underlines the importance of STEC diagnostic tests in all children with HUS, including those with an atypical presentation, and emphasizes the importance of molecular and serotyping assays to estimate the virulence of an STEC strain.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>28343354</pmid><doi>10.1007/s00467-017-3642-3</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0931-041X |
| ispartof | Pediatric nephrology (Berlin, West), 2017-07, Vol.32 (7), p.1263-1268 |
| issn | 0931-041X 1432-198X |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5440534 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Analysis Anti-Bacterial Agents - therapeutic use Antibodies, Monoclonal, Humanized - therapeutic use Bacterial toxins Biopsy Blood Culture Brief Report Care and treatment Causes of Ceftriaxone - therapeutic use Central nervous system Children Complications Diagnosis Dosage and administration Escherichia coli Escherichia coli Infections - blood Escherichia coli Infections - complications Escherichia coli Infections - drug therapy Escherichia coli Infections - microbiology Hemolytic uremic syndrome Hemolytic-Uremic Syndrome - blood Hemolytic-Uremic Syndrome - complications Hemolytic-Uremic Syndrome - drug therapy Hemolytic-Uremic Syndrome - microbiology Humans Infant Kidneys Liver - pathology Magnetic Resonance Imaging Male Medicine Medicine & Public Health Midazolam - therapeutic use Multiple Organ Failure - blood Multiple Organ Failure - complications Multiple Organ Failure - drug therapy Multiple Organ Failure - microbiology Nephrology Pediatrics Real-Time Polymerase Chain Reaction Renal failure Resuscitation Serotypes Serotyping Serotyping - methods Shiga toxin Shiga Toxin 2 - isolation & purification Shiga Toxin 2 - toxicity Shiga-Toxigenic Escherichia coli - isolation & purification Shiga-Toxigenic Escherichia coli - metabolism Shiga-Toxigenic Escherichia coli - pathogenicity Thrombotic Microangiopathies - blood Thrombotic Microangiopathies - complications Thrombotic Microangiopathies - drug therapy Thrombotic Microangiopathies - microbiology Thrombotic microangiopathy Toxins Urology Virulence Virulence (Microbiology) |
| title | Unusual severe case of hemolytic uremic syndrome due to Shiga toxin 2d-producing E. coli O80:H2 |
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