Pathogen
- Shiga toxin-producing E. coli (STEC)
- E. coli O157:H7 - cause severe disease, most notably painful bloody diarrhea, and the Hemolytic uremic syndrome (HUS)
Natural history
- Diarrhea is considered the first day of illness. Diarrhea is initially nonbloody, but in most patients, becomes visibly bloody one to three days later.
- Abdominal pain is common
- Fever at presentation is uncommon, although many patients report fevers early in illness (ie, before they present for care).
- HUS, if it occurs, is usually established between days 5 and 13 of illness.
Treatment
- Suspect this in all patients with bloody diarrhoea
- Diagnosis based on E. coli O157:H7 isolation of Shiga toxin
- Management - supportive
- Do not give antibiotics - do not reduce symptoms or complications of STEC infection and have been associated with development of HUS