The association between bacterial genotype of E coli 0157:H7 and CNS manifestations of childhood gastroenteritis-associated hemolytic uremic syndrome (D+HUS) was studied in 51 patients with HUS treated at the British Columbia’s Children’s Hospital, Vancouver, Canada. Of 51 children with HUS, 11 suffered neurologic complications that included encephalopathy in 6 and seizures in 7, with 2 deaths. No association with bacterial genotype was demonstrated. [1]
COMMENT: Seizures, encephalopathy, visual disturbances, and transient hemiparesis are the neurologic complications of E coli hemolytic uremic syndrome. Seizures, the most common symptom, occur from 4 to 12 days after onset of diarrhea. A number of factors may cause the CNS symptoms, but a specific bacterial genotype of E coli is not implicated. Prevention or timely diagnosis and treatment may diminish the incidence of neurologic complications of E coli 0157:H7 infection.
Risk of hemolytic uremic syndrome after sporadic E coli 0157:H7 infection: Results of a Canadian collaborative study [2]. Of 205 children with HUS, 77% had E coli 0157:H7 infection. A further 582 had E coli gastroenteritis. The risk of HUS in Alberta was 8.1%, compared to 31% in other Canadian referral centers.