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Clinical aspects of a nationwide epidemic of severe haemolytic uremic syndrome (HUS) in children

BACKGROUND: Report a nationwide epidemic of Shiga toxin-producing E. coli (STEC) O103:H25 causing hemolytic uremic syndrome (D+HUS) in children. METHODS: Description of clinical presentation, complications and outcome in a nationwide outbreak. RESULTS: Ten children (median age 4.3 years) developed H...

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Autores principales: Krogvold, Lars, Henrichsen, Thore, Bjerre, Anna, Brackman, Damien, Dollner, Henrik, Gudmundsdottir, Helga, Syversen, Gaute, Næss, Pål Aksel, Bangstad, Hans Jacob
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3160365/
https://www.ncbi.nlm.nih.gov/pubmed/21798000
http://dx.doi.org/10.1186/1757-7241-19-44
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author Krogvold, Lars
Henrichsen, Thore
Bjerre, Anna
Brackman, Damien
Dollner, Henrik
Gudmundsdottir, Helga
Syversen, Gaute
Næss, Pål Aksel
Bangstad, Hans Jacob
author_facet Krogvold, Lars
Henrichsen, Thore
Bjerre, Anna
Brackman, Damien
Dollner, Henrik
Gudmundsdottir, Helga
Syversen, Gaute
Næss, Pål Aksel
Bangstad, Hans Jacob
author_sort Krogvold, Lars
collection PubMed
description BACKGROUND: Report a nationwide epidemic of Shiga toxin-producing E. coli (STEC) O103:H25 causing hemolytic uremic syndrome (D+HUS) in children. METHODS: Description of clinical presentation, complications and outcome in a nationwide outbreak. RESULTS: Ten children (median age 4.3 years) developed HUS during the outbreak. One of these was presumed to be a part of the outbreak without microbiological proof. Eight of the patients were oligoanuric and in need of dialysis. Median need for dialysis was 15 days; one girl did not regain renal function and received a kidney transplant. Four patients had seizures and/or reduced consciousness. Cerebral oedema and herniation caused the death of a 4-year-old boy. Two patients developed necrosis of colon with perforation and one of them developed non-autoimmune diabetes. CONCLUSION: This outbreak of STEC was characterized by a high incidence of HUS among the infected children, and many developed severe renal disease and extrarenal complications. A likely explanation is that the O103:H25 (eae and stx(2)-positive) strain was highly pathogen, and we suggest that this serotype should be looked for in patients with HUS caused by STEC, especially in severe forms or outbreaks.
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spelling pubmed-31603652011-08-24 Clinical aspects of a nationwide epidemic of severe haemolytic uremic syndrome (HUS) in children Krogvold, Lars Henrichsen, Thore Bjerre, Anna Brackman, Damien Dollner, Henrik Gudmundsdottir, Helga Syversen, Gaute Næss, Pål Aksel Bangstad, Hans Jacob Scand J Trauma Resusc Emerg Med Original Research BACKGROUND: Report a nationwide epidemic of Shiga toxin-producing E. coli (STEC) O103:H25 causing hemolytic uremic syndrome (D+HUS) in children. METHODS: Description of clinical presentation, complications and outcome in a nationwide outbreak. RESULTS: Ten children (median age 4.3 years) developed HUS during the outbreak. One of these was presumed to be a part of the outbreak without microbiological proof. Eight of the patients were oligoanuric and in need of dialysis. Median need for dialysis was 15 days; one girl did not regain renal function and received a kidney transplant. Four patients had seizures and/or reduced consciousness. Cerebral oedema and herniation caused the death of a 4-year-old boy. Two patients developed necrosis of colon with perforation and one of them developed non-autoimmune diabetes. CONCLUSION: This outbreak of STEC was characterized by a high incidence of HUS among the infected children, and many developed severe renal disease and extrarenal complications. A likely explanation is that the O103:H25 (eae and stx(2)-positive) strain was highly pathogen, and we suggest that this serotype should be looked for in patients with HUS caused by STEC, especially in severe forms or outbreaks. BioMed Central 2011-07-28 /pmc/articles/PMC3160365/ /pubmed/21798000 http://dx.doi.org/10.1186/1757-7241-19-44 Text en Copyright ©2011 Krogvold et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Krogvold, Lars
Henrichsen, Thore
Bjerre, Anna
Brackman, Damien
Dollner, Henrik
Gudmundsdottir, Helga
Syversen, Gaute
Næss, Pål Aksel
Bangstad, Hans Jacob
Clinical aspects of a nationwide epidemic of severe haemolytic uremic syndrome (HUS) in children
title Clinical aspects of a nationwide epidemic of severe haemolytic uremic syndrome (HUS) in children
title_full Clinical aspects of a nationwide epidemic of severe haemolytic uremic syndrome (HUS) in children
title_fullStr Clinical aspects of a nationwide epidemic of severe haemolytic uremic syndrome (HUS) in children
title_full_unstemmed Clinical aspects of a nationwide epidemic of severe haemolytic uremic syndrome (HUS) in children
title_short Clinical aspects of a nationwide epidemic of severe haemolytic uremic syndrome (HUS) in children
title_sort clinical aspects of a nationwide epidemic of severe haemolytic uremic syndrome (hus) in children
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3160365/
https://www.ncbi.nlm.nih.gov/pubmed/21798000
http://dx.doi.org/10.1186/1757-7241-19-44
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