Successful Colectomy for Hemorrhagic Colitis with Hemolytic Uremic Syndrome and Acute Encephalopathy due to <b><i>Escherichia coli</i></b> O157 Infection

Abstract

An 81-year-old man was admitted to a primary care hospital due to bloody diarrhea. The findings of abdominal computed tomography indicated ischemic colitis, so conservative therapy was started. On the 4th hospital day, the patient was transferred to our hospital because of renal dysfunction. Physical examination showed clouding of consciousness and abdominal distention. Abdominal computed tomography revealed massive ascites and thickening of the whole colonic wall. With a diagnosis of acute abdomen, an emergent laparotomy was performed. Extended right hemicolectomy was performed because of severe ischemic change and necrosis of the right side of the colon. In the stool culture before the operation, Escherichia coli O157 and verotoxin were found, so this case was diagnosed as hemorrhagic colitis with hemolytic uremic syndrome and acute encephalopathy due to Escherichia coli O157 infection. Postoperatively, the hemolytic uremic syndrome and acute encephalopathy were prolonged. However, with intensive care, the patient recovered and was discharged on the 33rd postoperative day.

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.…”

“…Laboratory findings revealed unspecific changes such as mild to intense leucocytosis or slight inflammation. Microbiological assessments provided STEC positive stool cultures in four out of the eight cases (7,11,14,15) and CT scan was performed in six of the cases.…”

“…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.…”

Combined Treatment with Low Concentrations of Aqueous and Gaseous Chlorine Dioxide Inactivates Escherichia coli O157:H7 and Salmonella Typhimurium Inoculated on Paprika

“…Most cases of salmonellosis have been attributed to consuming poultry products [6], but the frequency of foodborne disease outbreaks associated with Salmonella in fresh produce has increased [7]. E. coli O157:H7 is also a threat to humans, as it causes hemorrhagic colitis and hemolytic uremic syndrome [8]. Feces of livestock can contaminate soil or irrigation water, and fruits and vegetables are not thermally processed after harvest.…”