A Case of Hemolytic Uremic Syndrome Documented Co-Infection of Vertoxin Producing Escherichia coli O157 and Other Pathogens.
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概要
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We reported a case of a 3-year-old girl with hemolytic uremic syndrome (HUS), which showed hemolytic anemia (Hemogulobin 8.2 g/dl, lactate dehydrogenase 1277 IU/1 and total bilirubin 0.6 mg/dl), small purpura on the skin (platelet 7.3×10<SUP>4</SUP>/μ1) and slightly decreased output of urine (creatinin 0.4 mg/dl and blood urea nitrogen 27.2 mg/dl). Verotoxin producing <I>Escherichia coli (E. coli)</I> O157 was not isolated, but <I>Salmonella agona</I> and <I>E. coli</I> O125, which is one of the enteropthogenic <I>E. coli</I>, were detected from her stool culture. However, the IgM antibody against verotoxin producing <I>E. coli</I> (VTEC) 0157 lipopolysaccharide was detected in both serum of the acute and convalescent phase by immunoblot assay. In addition verotoxin DNA was demonstrated in the stool by PCR method.<BR>Therefore, we think this HUS might be due to VTEC 0157, which must have been co-infected with <I>Salmonella agona</I> and <I>E. coli</I> O125. There have been four cases including the present case of co-infection with VTEC 0157 so far, and the other three cases were of the <I>Salmonella species</I>. Although the reason of co-infection was unknown, we may infer that food might be contaminated with some pathogens including <I>Salmonella</I> species or that these patients might be already infected with <I>Salmonella</I> species prior to VTEC infection. Even when some other pathogens were detected by a stool culture from a patient with HUS, we should pay attention to demonstrate associated of VTEC and HUS by the specific antibodies and PCR for verotoxin DNA.
- The Japanese Association for Infectious Diseasesの論文
The Japanese Association for Infectious Diseases | 論文
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