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General Reference ⬇

(E. coli Invasive Diarrhea) (Am J Publ Hlth 1997;87:176; Ann IM 1995;123:698; Nejm 1995;333:364)

Pathophys and Cause ⬆ ⬇

Pathophys:Colon wall invasion and toxin production

Epidemiology ⬆ ⬇

Most common cause of infectious bloody diarrhea in US. From manure and manure dust (Jama 2003;290:2709) contaminant of hamburger, drinking water, swimming beaches (Nejm 1994;331:579)

Signs and Symptoms ⬆ ⬇

Sx:Incubation period 1-3 d

Si:Low-grade fever, fecal leukocytes often present, initial watery stool becomes bloody; hemolytic-uremic syndrome and TTP

Lab and Xray ⬆ ⬇

Lab:Stool cultures on sorbitol-MacConkey agar; stool toxin titers

Treatment ⬆

Rx:Rehydration and supportive care; cipro or Tm/S DS bid × 3 d (Ann IM 1987;106:216) if must, but avoiding antibiotic rx may prevent HUS (Nejm 2000;342:1930)