1 research outputs found
Clinical aspects of a nationwide epidemic of severe haemolytic uremic syndrome (HUS) in children
Background: Report a nationwide epidemic of Shiga toxin-producing E. coli (STEC) O103:H25 causing hemolytic
uremic syndrome (D+HUS) in children.
Methods: Description of clinical presentation, complications and outcome in a nationwide outbreak.
Results: Ten children (median age 4.3 years) developed HUS during the outbreak. One of these was presumed to
be a part of the outbreak without microbiological proof. Eight of the patients were oligoanuric and in need of
dialysis. Median need for dialysis was 15 days; one girl did not regain renal function and received a kidney
transplant. Four patients had seizures and/or reduced consciousness. Cerebral oedema and herniation caused the
death of a 4-year-old boy. Two patients developed necrosis of colon with perforation and one of them developed
non-autoimmune diabetes.
Conclusion: This outbreak of STEC was characterized by a high incidence of HUS among the infected children,
and many developed severe renal disease and extrarenal complications. A likely explanation is that the O103:H25
(eae and stx2-positive) strain was highly pathogen, and we suggest that this serotype should be looked for in
patients with HUS caused by STEC, especially in severe forms or outbreaks