2012 Volume 3 Issue 1 Pages 69-72
Escherichia coli O111 is a verotoxin-producing enterohemorrhagic E coli (EHEC) as is E coli O157 serotype. Verotoxin may cause bloody diarrhea and abdominal pain, hemolytic uremic syndrome (HUS), as well as fatal acute encephalitis. We report the case of a 2-year-old boy who was healthy until the day of admission. The boy experienced vomiting and diarrhea and passed bloody stools. Because of rapid progression of acute kidney injury (AKI), continuous renal replacement therapy (CRRT) was administered the next day, the dialysis flow rate was kept low because he experienced convulsions and also to prevent an increase in intracranial pressure (ICP). His renal function improved after consecutive attempts of CRRT for 6 days, followed by peritoneal dialysis for another 2 weeks. He was discharged without sequelae. E coli O111 infection, similar to E coli O157 infection, is likely to progress to a more severe disease in the case of infants. CRRT is indicated when young infants present with severe HUS and show progression to a stage of AKI. If encephalopathy is suspected, a low dialysis flow rate should be considered to prevent the increase in ICP.
