Last reviewed: November 2017
Last updated: February  2017

Summary

Definition

History and exam

Key diagnostic factors

  • diarrhea, especially bloody diarrhea
  • childhood, especially age <5 years
  • abdominal pain, nausea, vomiting
  • absence of fever

Other diagnostic factors

  • known community outbreak of toxogenic E coli
  • history of ingestion of food that may have been contaminated with E coli O157:H7
  • unusual side effect seen after treatment with cyclosporine, chemotherapy, quinine
  • pregnancy or postpartum status
  • unusual side effect seen after bone marrow transplant
  • family history of possible HUS-like syndrome

Risk factors

  • ingestion of contaminated food or water
  • known community outbreak of toxogenic E coli
  • exposure to infected individuals in institutional settings
  • genetic predisposition
  • bone marrow transplant
  • exposure to cyclosporine, some chemotherapy agents, targeted cancer agents, and quinine
  • pregnancy- or postpartum-related

Diagnostic investigations

1st investigations to order

  • CBC
  • peripheral blood smear
  • renal function/creatinine
  • PT, PTT
  • LDH
  • haptoglobin
  • stool culture on sorbitol-MacConkey agar to detect Escherichia coli O157:H7
  • proteins involved in complement regulation
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Ann Zimrin

Associate Professor

University of Maryland School of Medicine

Marlene and Stewart Greenebaum Cancer Center

Baltimore

MD

Disclosures

AZ declares that she has no competing interests.

John Hess

Professor of Pathology and Medicine

Department of Pathology

University of Maryland School of Medicine

Baltimore

MD

Disclosures

JH declares that he has no competing interests.

Peer reviewers VIEW ALL

Chief Fellow

Section of Hematology and Oncology

Department of Internal Medicine

Wake Forest University Baptist Medical Center

Winston-Salem

NC

Disclosures

RC declares that she has no competing interests.

Use of this content is subject to our disclaimer