Enterohemorrhagic E. coli O157 infection in perinatal period developed into hemolytic-uremic syndrome

Abstract

A 31-year-old woman, gravida 2 para 2, admitted due to acute abdominal pain and diarrhea at week 29 of her pregnancy was threatened with premature labor and acute enterocolitis; intravenous ritodrine hydrochloride was started. She showed bloody diarrhea and at 29 weeks and 2 days gestation, spontaneous labor began. Due to arm presentation, an emergency caesarean section was performed. On postoperative day 2, Shiga toxin 2 positive enterohaemorrhagic E. coli (EHEC) O157 was found. On postoperative day 4, thrombocytopenia, haemolytic uremic syndrome (HUS), and renal failure developed. After four plasma exchanges, her symptoms had improved and tested negative for O157 on day 10.

For the health of the mother, we recommend inducing early delivery for a pregnancy presenting with bloody diarrhea and testing positive for EHEC O157 which may progress to Shiga toxin 2 infection.