Escherichia Coli O157 H7
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Contents |
Etiology
- risk factors for E coli associated HUS
- age > 65 years
- age < 15 years
- low gastric acid production
- gastrectomy
- medication
Epidemiology
- 1993 multi-state outbreak associated with undercooked hamburgers
- multi-county outbreaks in California associated with raw alfalfa sprouts &/or clover-seed sprouts [4]
Pathology
- hemorrhagic colitis
- hemolytic uremic syndrome ( HUS) 10% (includes TTP
- most common cause of renal disease in children
Clinical-manifestations
- incubation period: 6 +/- 2 days
- abdominal cramping & diarrhea, becoming bloody
- vomiting (50%)
- fever (30%)
- resolution in 1 week
Laboratory
- laboratory indicators of HUS risk
- leukocytosis
- serum albumin < 3.5 g/ dL
- E coli O157:H7 is cultured on sorbitol agar
- Escherichia coli O157 Ag
- also see hemolytic uremic syndrome ( HUS)
Complications
- long term health risks of
- hypertension
- structural & functional renal impairment [7]
Management
- treatment is generally supportive
- avoid antimotility agents -
- slows elimination of bacteria
- may increase risk of hemolytic-uremic syndrome [5]
- risk of hemolytic-uremic syndrome not associated with antibiotic treatment [5]
More General Terms
Additional Terms
References
- Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook, Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 226
- Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 498, 535
- Prescriber's Letter 7(8):45 2000
- Journal Watch 21(18):149, 2001 Mohle-Boetani JC, et al Escherichia coli O157 and Salmonella infections associated with sprouts in California, 1996-1998 Ann Intern Med 2001, 135:239 PMID: [1]
- Medical Knowledge Self Assessment Program (MKSAP) 14, 15 American College of Physicians, Philadelphia 2006, 2009
- Hamburger - Preparation Safety [2]
- Clark WF et al Long term risk for hypertension, renal impairment, and cardiovascular disease after gastroenteritis from drinking water contaminated with Escherichia coli O157:H7: a prospective cohort study BMJ 2010; 341:c6020 <PubMed> PMID: [3] <Internet> [4]
