Successful Treatment of Enterohemorrhagic Escherichia coliO111-Induced Acute Encephalopathy and Hemolytic-Uremic Syndrome With Plasma Diafiltration

摘要

A 7-year-old girl was referred to us with a 2-day history of abdominal pain and bloody stools. Enterohemorrhagic Escherichia coli (EHEC) Olll producing shiga toxin (STx)-l and 2 was detected in the stool culture. She became lethargic on day 3 of hospitalization. Laboratory examinations revealed thrombocytopenia, hemolytic anemia and acute renal failure. On day 5 of hospitalization, she experienced alterations in her consciousness level with abnormal findings of magnetic resonance image. These findings indicated the diagnosis of EHEC Olll-associated hemolytic uremic syndrome (HUS) with acute encephalopathy. Treatment with continuous hemodiafiltration (CHDF) was initiated, but her disease condition did not improve (Fig. 1 A).