Clinical aspects of a nationwide epidemic of severe haemolytic uremic syndrome (HUS) in children
Krogvold, Lars; Henrichsen, Thore Andre; Bjerre, Anna Kristina; Brackman, Damien; Døllner, Henrik; Gudmundsdottir, Helga; Næss, Pål Aksel; Syversen, Gaute; Bangstad, Hans J
Journal article, Peer reviewed
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http://hdl.handle.net/11250/1607141Utgivelsesdato
2011Metadata
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Originalversjon
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2011, 19 10.1186/1757-7241-19-44Sammendrag
Background: Report a nationwide epidemic of Shiga toxin-producing E. coli (STEC) O103:H25 causing hemolytic
uremic syndrome (D+HUS) in children.
Methods: Description of clinical presentation, complications and outcome in a nationwide outbreak.
Results: Ten children (median age 4.3 years) developed HUS during the outbreak. One of these was presumed to
be a part of the outbreak without microbiological proof. Eight of the patients were oligoanuric and in need of
dialysis. Median need for dialysis was 15 days; one girl did not regain renal function and received a kidney
transplant. Four patients had seizures and/or reduced consciousness. Cerebral oedema and herniation caused the
death of a 4-year-old boy. Two patients developed necrosis of colon with perforation and one of them developed
non-autoimmune diabetes.
Conclusion: This outbreak of STEC was characterized by a high incidence of HUS among the infected children,
and many developed severe renal disease and extrarenal complications. A likely explanation is that the O103:H25
(eae and stx2-positive) strain was highly pathogen, and we suggest that this serotype should be looked for in
patients with HUS caused by STEC, especially in severe forms or outbreaks.