Chapter 9 : Escherichia coli O157:H7

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O157:H7 can cause nonbloody diarrhea, bloody diarrhea (hemorrhagic colitis), hemolytic uremic syndrome (HUS), thrombotic thrombocytopenic purpura (TIP), and death. Illness typically begins with severe abdominal cramps and nonbloody diarrhea, which often becomes bloody by the second or third day of illness. Thus, although bloody stools are common with O157:H7 infection, the diagnosis must be considered for patients with nonbloody diarrhea as well. Differential diagnosis of colitis caused by O157:H7 have been provided in this chapter. Probably the most common cause of acute renal failure in children, HUS is characterized by microangiopathic hemolytic anemia, thrombocytopenia, renal failure, and central nervous system manifestations. Most information about modes of transmission of O157:H7 infection has been derived from outbreak investigations. Although most O157:H7 strains are susceptible to antimicrobial agents used for enteric infections, such treatment has not been demonstrated to improve the course of illness or to prevent complications. The authors recommend that clinicians urge their clinical laboratories to culture for O157:H7 by using sorbitol-MacConkey medium, at a minimum from stools with visible blood. They should advise patients with diarrhea and parents of children with diarrhea that washing hands with soap after bowel movements is the most important measure in preventing the spread of infection.

Citation: Griffin P, Boyce T. 1998. Escherichia coli O157:H7, p 137-146. In Scheld W, Armstrong D, Hughes J (ed), Emerging Infections 1. ASM Press, Washington, DC. doi: 10.1128/9781555816940.ch9
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Table 1.

Differential diagnosis of colitis caused by O157:H7

Citation: Griffin P, Boyce T. 1998. Escherichia coli O157:H7, p 137-146. In Scheld W, Armstrong D, Hughes J (ed), Emerging Infections 1. ASM Press, Washington, DC. doi: 10.1128/9781555816940.ch9

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