A 5-year-old girl is brought into her primary care physician due to diarrhea lasting one week. Initially the diarrhea began as 5-6 watery stools per day but has turned bloody over the past two days. There has been no recent travel, and she has not significant past medical history. Vital signs reveal that she is mildly tachycardic but afebrile. On physical examination, the girl appears slightly lethargic with sunken eyes and dry lips. She is hunched over with cramping abdominal pain.
Which of the following is a potential complication of the organism causing her symptoms?
C) Hemolytic-uremic syndrome
This girl most likely has a bacterial diarrhea infection from Shiga toxin-producing Escherichia coli. This infection manifests as a watery diarrhea that turns bloody after 1-5 days in 80% of patients. Patients are typically afebrile but experience severe, cramping abdominal pain. As the Shiga toxin is absorbed into the bloodstream, it passes through the glomeruli of the kidneys and damages the endothelial cells, leading to renal failure and intravascular coagulation.
Answer choice A: Bacteremia, is incorrect. Salmonella infections can lead to bacteremia but this is not an expected complication of Escherichia coli enteric infection.
Answer choice B: Guillain-Barre syndrome, is incorrect. Campylobacter jejuni infections can lead to Guillain-Barre syndrome, but this is not an expected complication of Escherichia coli enteric infection
Answer choice D: Inflammatory bowel disease is incorrect. Escherichia coli enteric infection does not lead to inflammatory bowel disease.
Answer choice E: Reactive arthritis is incorrect. Campylobacter, Salmonella, Shigella, or Yersinia infection can lead to reactive arthritis, but this is not an expected complication of Escherichia coli enteric infection.
Key Learning Point
Escherichia coli enteric infection can lead to hemolytic-uremic syndrome.
