Most cases of Escherichia coli infection are foodborne.
Enterotoxigenic E coli (ETEC) is the most common cause of traveller's diarrhoea.
Diagnosis is made based on stool culture, with serotyping for greater specificity.
Treatment is supportive, with rehydration and correction of electrolyte imbalance.
Use of antibiotics is controversial and in most cases not necessary, except possibly in traveller's diarrhoea.
Ten percent of patients with E coli O157:H7 infection develop haemolytic uraemic syndrome.
Escherichia coli is a gram-negative, rod-shaped bacterium. It is a commensal organism that colonises the gastrointestinal tract within a few hours of birth. E coli becomes pathogenic by acquiring virulence factors or genetic mutations, leading to a broad range of intestinal and extra-intestinal disease. Infection by pathogenic strains occurs through ingestion, usually via contaminated food or water.
History and exam
Eli D. Ehrenpreis, MD, FACG, AGAF
Professor of Medicine
Rosalind Franklin University Medical School
Associate Director for Research
Internal Medicine Residency
Advocate Lutheran General Hospital
Adjunct Professor of Pediatric Gastroenterology
University of Miami Miller Medical School
EDE is a consultant for Pediatric Pharmaceuticals, Inc.
Dr Eli D. Ehrenpreis would like to gratefully acknowledge Dr Alexandra Kent and Professor Satis Keshav, the previous contributors to this topic.
AK and SK declare that they have no competing interests.
Andrew Poullis, BSc, MBBS, MD, FRCP
St George’s Hospital
AP declares that he has no competing interests.
Fiona Cooke, MA, PhD, MSc, FRCPath, MRCP, DTM&H
Research Fellow and Medical Microbiologist
Wellcome Trust Sanger Institute
Department of Microbiology
FC declares that she has no competing interests.
Houssam E. Mardini, MD, MPH, FACP
Voluntary Assistant Professor of Medicine
Digestive Health & Nutrition Center of Ashland
HEM declares that he has no competing interests.
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