scholarly journals Clostridium sordelliias a Cause of Fatal Septic Shock in a Child with Hemolytic Uremic Syndrome

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Rebekah Beyers ◽  
Michael Baldwin ◽  
Sevilay Dalabih ◽  
Abdallah Dalabih
Keyword(s):  
Septic Shock ◽  
Hemolytic Uremic Syndrome ◽  
Stool Culture ◽  
Toxic Shock ◽  
Unique Case ◽  
Clostridium Sordellii ◽  
First Case ◽  
Uremic Syndrome ◽  
Gynecologic Infection ◽  
Severe Septic Shock

Clostridium sordelliiis a toxin producing ubiquitous gram-positive anaerobe, mainly associated with trauma, soft tissue skin infections, and gynecologic infection. We report a unique case of a new strain ofClostridium sordellii(not present in the Center for Disease Control (CDC) database) infection induced toxic shock syndrome in a previously healthy two-year-old male with colitis-related hemolytic uremic syndrome (HUS). The patient presented with dehydration, vomiting, and bloody diarrhea. He was transferred to the pediatric critical care unit (PICU) for initiation of peritoneal dialysis (PD). Due to increased edema and intolerance of PD, he was transitioned to hemodialysis through a femoral vascular catheter. He subsequently developed severe septic shock with persistent leukocytosis and hypotension, resulting in subsequent death. Stool culture confirmed Shiga toxin producingEscherichia coli 0157:H7. A blood culture was positively identified forClostridium sordellii.Clostridium sordelliis rarely reported in children; to our knowledge this is the first case described in a pediatric patient with HUS.

scholarly journals A Unique Case of Hemolytic Uremic Syndrome Secondary to Enteropathogenic E. Coli

2020 ◽  
Author(s):  
Blessie Nelson ◽  
Angelina Hong ◽  
Fatima Iqbal ◽  
Bagi Jana
Keyword(s):  
Hemolytic Uremic Syndrome ◽  
Unique Case ◽  
E Coli ◽  
Uremic Syndrome

Ciprofloxacin-Associated Hemolytic-Uremic Syndrome

2002 ◽  
Vol 36 (6) ◽  
pp. 1000-1002 ◽  
Author(s):  
David S Allan ◽  
Cheryl M Thompson ◽  
Robert M Barr ◽  
William F Clark ◽  
Ian H Chin-Yee
Keyword(s):  
Hemolytic Uremic Syndrome ◽  
Lymphoblastic Leukemia ◽  
Probability Scale ◽  
Thrombocytopenic Purpura ◽  
Cell Counts ◽  
Case Summary ◽  
First Case ◽  
Oliguric Renal Failure ◽  
Uremic Syndrome ◽  
Oral Ciprofloxacin

OBJECTIVE: To report the first case of ciprofloxacin-associated hemolytic-uremic syndrome (HUS). CASE SUMMARY: A 53-year-old white man was treated with chemotherapy for acute lymphoblastic leukemia. Four weeks after initiation of treatment, he recovered his blood cell counts, but developed fever and was prescribed oral ciprofloxacin 500 mg twice daily. After 4 doses, he developed the typical features of HUS manifested by microangiopathic hemolytic anemia, oliguric renal failure, and thrombocytopenia. The medication was withdrawn, and he received 5 sessions of plasma exchange. He recovered completely and has normal renal function. DISCUSSION: Secondary HUS or its related syndrome, thrombotic thrombocytopenic purpura (TTP), is uncommon, but has been reported in association with cancer, chemotherapy, and a variety of medications. Our case represents a possible adverse drug reaction to ciprofloxacin according to the Naranjo probability scale. It is the first reported case of HUS associated with ciprofloxacin. CONCLUSIONS: Ciprofloxacin use was followed by HUS in our patient and was possibly causally related. Early detection, discontinuation of the offending medication, and treatment of HUS/TTP is critical.

scholarly journals MO1030THE FIRST CASE OF ATYPICAL HEMOLYTIC UREMIC SYNDROME (AHUS) FEATURES IN AN EXPERIMENTAL MODEL

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Guido Gembillo ◽  
Guido Bellinghieri ◽  
Vincenzo Savica ◽  
Rossella Siligato ◽  
Domenico Santoro
Keyword(s):  
Hemolytic Uremic Syndrome ◽  
Atypical Hemolytic Uremic Syndrome ◽  
Rabbit Model ◽  
Acute Onset ◽  
Glomerular Lesion ◽  
First Case ◽  
Uremic Syndrome ◽  
Collecting Tubules ◽  
Convoluted Tubules ◽  
Glomerular Tuft

Abstract Background and Aims Thrombotic Microangiopathies (TM) are three distinct clinical syndromes presenting the same histological renal pattern: typical and atypical Hemolytic Uremic Syndrome (SEU- aSEU) and Thrombotic Thrombocytopenic Purpura (TTP). So far, the first report of a TM has been generally attributed to Eli Moschowitz. In 1922 he described the case of a 16 years old girl who died after acute onset of fever with petechial lesions and autoptic findings of hyaline thrombosis of terminal arterioles and capillaries, thus profiling the first case of TTP. Only in the 1955, Conrad Gasser described the first medical record of HUS, describing the case of a patient with a manifestation of bilateral necrosis of the renal cortex. We describe the first reported case of a Thrombotic Microangiopathy, in particular an experimentally induced aHUS by Richard M. Pearce in 1909. In this case, the trigger leading to aHUS was represented by snake venom injection in an experimental rabbit model. Method Pearce described acute glomerular lesions produced in the rabbit using dried venom of rattlesnake Crotalus Adamanteus. It was dissolved in salt solution in the proportion of 0.25 of a milligram to one cubic centimeter, rising gradually to two milligrams, and then followed by doses of 0.5 of a milligram of fresh venom at various intervals. The intervals between injections depended on the general condition of the animal and the amount of albuminuria. Results Rabbit kidneys showed well marked hemorrhagic and exudative lesions in the glomeruli; hyaline, granular, blood, and hemoglobin casts in both convoluted and collecting tubules; and granular degeneration of the epithelium of the convoluted tubules and loops of Henle. Pearce also described a “penetration of the cells of the compressed glomerular tuft into the mass of hemorrhage lying either in the tuft itself or in the capsular space” (Figure 1). In animals surviving 20-30 days after the first injection of the venom, the acute lesions were demonstrated to subside at the microscopic examination and their earlier presence was marked by “occasional casts and compressed masses of red cells in the glomerular spaces and tufts”. At the same time other models also showed “extensive granular degeneration of the convoluted tubules and many casts”. The renal autoptic findings presented the features of a vascular nephritis with severe endothelial changes. Conclusion Glomerular and tubular lesions of rabbits’ kidneys induced by crotalus’s venom showed typical features of what is today defined as aHUS. In this first experiment, the author described a glomerular tuft as “more analogous to the organization of a red thrombus than it is to any form of glomerular lesion known in man”, so we can affirm that Pearce described, ante litteram TMA histological features many years before other scientists.

scholarly journals An Unconventional Diagnostic Method for Cryptosporidial Enteritis in a Healthy Host: Never Call It Quits!

2019 ◽  
Vol 13 (3) ◽  
pp. 526-531
Author(s):  
Shivantha Amarnath ◽  
Cheikh Talal El Imad ◽  
Kingsley Ebare ◽  
Hueizhi Wu ◽  
Stephen Mulrooney
Keyword(s):  
Diagnostic Method ◽  
Stool Culture ◽  
Watery Diarrhea ◽  
Peptic Ulcers ◽  
Unique Case ◽  
First Case ◽  
The Usa ◽  
History Of ◽  
Rising Incidence ◽  
Systemic Symptoms

Cryptosporidial enteritis has a rising incidence in the USA, mostly affecting immunocompromised individuals and children. It has a self-limiting course in healthy hosts. Herein, we present a unique case of a healthy middle-aged female who presented with a 1-month history of voluminous watery diarrhea and acute blood loss anemia. Cryptosporidial enteritis was diagnosed based on endoscopy with biopsy-proven evidence of 2 jejunal peptic ulcers infected with Cryptosporidiumspp. that was originally missed on routine stool culture, ova and parasite tests. The patient was successfully treated with nitazoxanide,and eradication of the protozoan was also confirmed on repeat endoscopic biopsies of the ulcer that were carried out 6 months later. To our knowledge, this is the first case to be reported in the literature with infective colonization of peptic ulcers with Cryptosporidiumspp.with consequent systemic symptoms.

scholarly journals A Unique Case of Unilateral Lower Extremity Sparing Systemic Peripheral Gangrene

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Alexey Markelov ◽  
Steven DeFroda ◽  
Leopoldo Baccaro ◽  
Jamie Bastidas
Keyword(s):  
Septic Shock ◽  
Lower Extremity ◽  
External Iliac Artery ◽  
Artery Occlusion ◽  
Upper Extremities ◽  
Vasopressor Therapy ◽  
Unique Case ◽  
Iliac Artery Occlusion ◽  
Peripheral Gangrene ◽  
Severe Septic Shock

We present here the case of a 70-year-old female who developed a systemic peripheral gangrene in both of her upper extremities (all fingers) and her right foot due to a severe septic shock requiring a systemic vasopressor therapy. Interestingly, the patient’s left foot remained spared from gangrenous changes possibly due to a chronic external iliac artery occlusion and thus the lower concentration of vasopressors in that extremity.

Recurrent Hemolytic Uremic Syndrome Secondary to Escherichia coli 0157:H7 Infection

PEDIATRICS ◽  
1993 ◽  
Vol 91 (3) ◽  
pp. 666-668
Author(s):  
RICHARD L. SIEGLER ◽  
PATRICIA M. GRIFFIN ◽  
TIMOTHY J. BARRETT ◽  
NANCY A. STROCKBINE
Keyword(s):  
Escherichia Coli ◽  
Case Report ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Hemolytic Uremic Syndrome ◽  
Good Health ◽  
Stool Culture ◽  
Ocular Involvement ◽  
Uremic Syndrome ◽  
Initial Episode

Recurrence of the hemolytic uremic syndrome (HUS) is unusual; most recurrent cases are atypical,1 that is, not preceded by the customary diarrheal prodrome. We report a case in which results of serologic tests and stool culture provided evidence that both the initial episode and the recurrence followed diarrhea caused by Escherichia coli 0157:H7. This child was previously described because of severe ocular involvement that followed the initial HUS episode.2) CASE REPORT A 16-month-old white boy from rural Idaho was in good health until about 1 week before admission, when a respiratory tract infection complicated by otitis media developed. He was treated with amoxicillin.

Campylobacter jejuni-Associated Hemolytic-Uremic Syndrome in a Mother and Daughter

PEDIATRICS ◽  
1983 ◽  
Vol 71 (2) ◽  
pp. 253-256
Author(s):  
Bruce N. Chamovitz ◽  
Alan I. Hartstein ◽  
Steven R. Alexander ◽  
Annie B. Terry ◽  
Priscilla Short ◽  
...  
Keyword(s):  
Hemolytic Uremic Syndrome ◽  
Campylobacter Jejuni ◽  
Systematic Investigation ◽  
Stool Culture ◽  
Immunofluorescent Antibody ◽  
Mother And Daughter ◽  
Antibody Titers ◽  
Uremic Syndrome ◽  
Indirect Immunofluorescent ◽  
Stool Cultures

A mother and daughter with Campylobacter jejuni-associated hemolytic-uremic syndrome (HUS) are discussed. The mother was hospitalized with bloody diarrhea and HUS; C jejuni was isolated from her stool. The 2-year-old daughter had been admitted five days prior to her mother with HUS following a three-day prodrome of vomiting and diarrhea. Multiple stool cultures were negative for enteric pathogens; however, cultures were not obtained until the eighth hospital day and after antibiotic therapy. Extensive investigation failed to identify another cause for the diarrheal illness or HUS in our patients. Indirect immunofluorescent antibody titers for C jejuni were 1:32 and 1:16 for the mother and daughter, respectively. An asymptomatic 9-month-old son had C jejuni isolated from his stool and had an immunofluorescent antibody titer of 1:64. Three other family members were asymptomatic, stool-culture negative, and had immunofluorescent antibody titers ≤ 1:4. The susceptibility to develop HUS following an enteric antigenic stimulus is illustrated by the patients presented. The need for systematic investigation of all HUS cases for potential susceptibility markers, as well as an exhaustive etiologic search, is emphasized.

scholarly journals Serogroup-Specific Bacterial Engineered Glycoproteins as Novel Antigenic Targets for Diagnosis of Shiga Toxin-Producing-Escherichia coli-Associated Hemolytic-Uremic Syndrome

2014 ◽  
Vol 53 (2) ◽  
pp. 528-538 ◽  
Author(s):  
Luciano J. Melli ◽  
Andrés E. Ciocchini ◽  
Ana J. Caillava ◽  
Nicolás Vozza ◽  
Isabel Chinen ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Hemolytic Uremic Syndrome ◽  
Shiga Toxin ◽  
Diagnostic Procedures ◽  
Stool Culture ◽  
Human Infection ◽  
Healthy Children ◽  
Content Type ◽  
E Coli ◽  
Uremic Syndrome

Human infection with Shiga toxin-producingEscherichia coli(STEC) is a major cause of postdiarrheal hemolytic-uremic syndrome (HUS), a life-threatening condition characterized by hemolytic anemia, thrombocytopenia, and acute renal failure.E. coliO157:H7 is the dominant STEC serotype associated with HUS worldwide, although non-O157 STEC serogroups can cause a similar disease. The detection of anti-O157E. colilipopolysaccharide (LPS) antibodies in combination with stool culture and detection of free fecal Shiga toxin considerably improves the diagnosis of STEC infections. In the present study, we exploited a bacterial glycoengineering technology to develop recombinant glycoproteins consisting of the O157, O145, or O121 polysaccharide attached to a carrier protein as serogroup-specific antigens for the serological diagnosis of STEC-associated HUS. Our results demonstrate that using these antigens in indirect ELISAs (glyco-iELISAs), it is possible to clearly discriminate between STEC O157-, O145-, and O121-infected patients and healthy children, as well as to confirm the diagnosis in HUS patients for whom the classical diagnostic procedures failed. Interestingly, a specific IgM response was detected in almost all the analyzed samples, indicating that it is possible to detect the infection in the early stages of the disease. Additionally, in all the culture-positive HUS patients, the serotype identified by glyco-iELISAs was in accordance with the serotype of the isolated strain, indicating that these antigens are valuable not only for diagnosing HUS caused by the O157, O145, and O121 serogroups but also for serotyping and guiding the subsequent steps to confirm diagnosis.

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