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Comparative Study
. 2011 Jul 28:19:44.
doi: 10.1186/1757-7241-19-44.

Clinical aspects of a nationwide epidemic of severe haemolytic uremic syndrome (HUS) in children

Lars Krogvold  1 , Thore Henrichsen, Anna Bjerre, Damien Brackman, Henrik Dollner, Helga Gudmundsdottir, Gaute Syversen, Pål Aksel Næss, Hans Jacob Bangstad
Affiliations
Comparative Study

Clinical aspects of a nationwide epidemic of severe haemolytic uremic syndrome (HUS) in children

Lars Krogvold et al. Scand J Trauma Resusc Emerg Med. .

Abstract

Background: Report a nationwide epidemic of Shiga toxin-producing E. coli (STEC) O103:H25 causing hemolytic uremic syndrome (D+HUS) in children.

Methods: Description of clinical presentation, complications and outcome in a nationwide outbreak.

Results: Ten children (median age 4.3 years) developed HUS during the outbreak. One of these was presumed to be a part of the outbreak without microbiological proof. Eight of the patients were oligoanuric and in need of dialysis. Median need for dialysis was 15 days; one girl did not regain renal function and received a kidney transplant. Four patients had seizures and/or reduced consciousness. Cerebral oedema and herniation caused the death of a 4-year-old boy. Two patients developed necrosis of colon with perforation and one of them developed non-autoimmune diabetes.

Conclusion: This outbreak of STEC was characterized by a high incidence of HUS among the infected children, and many developed severe renal disease and extrarenal complications. A likely explanation is that the O103:H25 (eae and stx2-positive) strain was highly pathogen, and we suggest that this serotype should be looked for in patients with HUS caused by STEC, especially in severe forms or outbreaks.

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References

    1. Tarr PI, Gordon CA, Chandler WL. Shiga-toxin-producing Escherichia coli and haemolytic uraemic syndrome. Lancet. 2005;365:1073–1086. - PubMed
    1. Lynn RM, O'Brien SJ, Taylor CM, Adak GK, Chart H, Cheasty T, Coia JE, Gillespie IA, Locking ME, Reilly WJ, Smith HR, Waters A, Willshae GA. Childhood hemolytic uremic syndrome, United Kingdom and Ireland. Emerg Infect Dis. 2005;11:590–596. - PMC - PubMed
    1. Banatvala N, Griffin PM, Greene KD, Barrett TJ, Bibb WF, Green JH, Wells JG. The United States National Prospective Hemolytic Uremic Syndrome Study: microbiologic, serologic, clinical, and epidemiologic findings. J Infect Dis. 2001;183:1063–1070. doi: 10.1086/319269. - DOI - PubMed
    1. Bell BP, Goldoft M, Griffin PM, Davis MA, Gordon DC, Tarr PI, Bartleson CA, Lewis JH, Barrett TJ, Wells JG, Baron R, Kobayashi J. A multistate outbreak of Escherichia coli O157:H7-associated bloody diarrhea and hemolytic uremic syndrome from hamburgers. The Washington experience. JAMA. 1994;272:1349–1353. doi: 10.1001/jama.272.17.1349. - DOI - PubMed
    1. Brooks JT, Sowers EG, Wells JG, Greene KD, Griffin PM, Hoekstra RM, Strockbine NA. Non-O157 Shiga toxin-producing Escherichia coli infections in the United States, 1983-2002. J Infect Dis. 2005;192:1422–1429. doi: 10.1086/466536. - DOI - PubMed

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