Haemolytic uraemic syndrome - a rare case report of bloody diarrhoea in adults

Abstract

Background Haemolytic uraemic syndrome is a rarely seen in adults often leading to critical illness. This case highlights how difficult it can be to establish a diagnosis and treat when a patient presents with bloody diarrhoea. Case presentation A 17-year-old Iraqi man presented to the emergency department with abdominal pain and bloody diarrhoea. He was initially treated as acute appendicitis, undergoing an appendectomy but following a recurrence in his symptoms a colonoscopy was performed. A diagnosis of shiga toxin-producing Escherichia coli leading to HUS was suspected following histology obtained at colonoscopy and this was confirmed on antibody testing. Despite intravenous fluids and supportive therapy the patient’s symptoms and condition deteriorated. He developed seizures and acute renal failure requiring intubation and plasma exchange in the intensive care setting. He eventually required treatment with ecluzimab therapy; a monoclonal antibody and subsequently made a full recovery. Conclusions Haemolytic uraemic syndrome is a triad of progressive renal failure, thrombocytopenia and haemolytic anaemia which is a condition rarely seen in adults. It is usually associated with an E. coli infection and supportive therapy remains the mainstay of treatment.

A Successful Approach in Diagnosing Shiga - Toxin Producing Escherichia coli -Induced Colitis

“…There are few published case reports on ischemic colitis in adults (Table 2), due to Shiga-like producing toxin E coli (7,(10)(11)(12)(13)(14)(15)(16). The mostly found clinical features were abdominal pain, bloody diarrhoea, with or without fever.…”

“…Two patients with colon necrosis (14,15) and one with faecal peritonitis (13) underwent surgical interventions with favourable outcome All of them received at least one day antibiotics: quinolones, cephalosporins, penicillins, metronidazole, known for their risk of triggering HUS, but only the two cases of extreme ages developed HUS (15,16).…”

A Successful Approach to Diagnosing Shiga-like Toxin-Producing Escherichia coli-Induced Colitis

“…There are few published case reports on ischemic colitis due to Shiga-like toxinproducing E. coli in adults (Table 2) [7,[13][14][15][16][17][18][19]. Among these reports, the most commonly found clinical features were abdominal pain and bloody diarrhea, with or without fever.…”

“…Two patients with colon necrosis [17,18] and one with fecal peritonitis [16] underwent surgical interventions with favorable outcomes. All the patients received antibiotics for at least one day, including quinolones, cephalosporins, penicillin, and metronidazole, which are known for their risk of triggering HUS, but only two patients of extreme age developed HUS [18,19].…”

The Silent Threat: Antimicrobial-Resistant Pathogens in Food-Producing Animals and Their Impact on Public Health

“…Campylobacter jejuni ( C. jejuni ) is a type of bacteria that is spiral-shaped and classified as Gram-negative and microaerophilic. This bacterial species is commonly found in the intestinal tracts of animals, particularly poultry and pigs [ 47 , 48 ], and can be transmitted to humans through the consumption of contaminated food or water [ 49 ]. Recently, it has been recognized as the primary culprit for bacterial foodborne illnesses in the U.S. [ 38 ].…”