Abstract
Shiga toxin 2 (Stx2) is a potent toxin produced by shiga toxin-producing <em>E. coli</em> (STEC) that is commonly linked to development of hemolytic uremic syndrome (HUS). An extremely rare complication of shiga toxin associated (STEC) hemolytic uremic syndrome is concomitant infection with <em>Clostridium septicum</em>.
Highlights
hemolytic uremic syndrome (HUS): Hemolytic Uremic Syndrome; shiga toxin-producing E. coli (STEC): Shiga Toxin-producing Escherichia coli; Stx2: Shiga toxin 2; MIC: Minimum Inhibitory Concentration
Shiga toxin 2 (Stx2) is a potent toxin produced by shiga toxin-producing E. coli (STEC) that is commonly linked to development of hemolytic uremic syndrome (HUS)
We report a case of a 4-year-old female who presented with bloody diarrhea, emesis and fever with STEC HUS complicated by C. septicum bacteremia who was successfully treated with a short course of metronidazole without hemodialysis or surgical intervention
Summary
HUS: Hemolytic Uremic Syndrome; STEC: Shiga Toxin-producing Escherichia coli; Stx2: Shiga toxin 2; MIC: Minimum Inhibitory Concentration. The majority of pediatric patients with HUS complicated by C. septicum infection had complications including CNS involvement, severe renal insult often requiring hemodialysis, and myonecrosis warranting invasive surgical intervention, and prolonged administration of multiple antimicrobial agents. There are 12 reported pediatric cases of HUS with concomitant C. septicum infection. Of the 12 reported cases, only 6 survived - all of whom warranted either surgical intervention, hemodialysis and prolonged antibiotic therapy, or both.
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