E. Coli 0157:H7 (cont.)
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
In this Article
- E. coli definition and facts
- What are E. coli 0157:H7 bacteria?
- 25 early and late symptoms of E. coli 0157:H7 infection
- How do people get E. coli 0157:H7 infections?
- What causes E. coli infection?
- Is E. coli 0157:H7 contagious?
- Is there a test for E. coli?
- What is the treatment for E. coli 0157:H7?
- How can I prevent from getting E. coli?
- What are the complications of infection with E. coli 0157:H7?
- What kind of doctor(s) treat E. coli 0157:H7 infections?
- Other enterohemorrhagic E. coli strains (for example, 0145, 026:H11, 0104:H4 and 0121)
- Summer Food Safety FAQs
What are the complications of infection with E. coli 0157:H7?
Although these conditions have been presented in the symptoms section, they are presented here again because they are actual complications that can occur after the initial disease begins. Patients without these complications usually have excellent outcomes (a good prognosis). Individuals who develop the following complications have outcomes that range from good to poor, depending on their overall health and how quickly they are diagnosed, treated, and respond to treatment.
Hemorrhagic diarrhea (hemorrhagic enterocolitis)
The incubation period between exposure to EHEC bacteria, including E. coli O157:H7, and the onset of symptoms is usually three to four days but may be longer in some individuals. Symptoms of EHEC infection include severe abdominal pain and abdominal tenderness which often is associated with bloody diarrhea. Curiously, there often is little or no fever. The diarrhea typically lasts for six to eight days. Dehydration and blood loss can lead to death in some patients if not corrected early.
Hemolytic-uremic syndrome (HUS)
Hemolytic-uremic syndrome (HUS) is the most worrisome complication of EHEC infection, especially in children, because it is a serious and potentially fatal complication. "Hemolytic" refers to the breakup of red blood cells which leads to anemia. There also is destruction of platelets which leads to low blood levels of platelets (thrombocytopenia), which in turn promotes abnormal bleeding. "Uremic" refers to failure of the kidneys. In addition, problems in the brain with seizures and coma may occur.
Hemolytic-uremic syndrome most commonly affects children under the ages of 10 years and is the most common cause of acute kidney failure in infants and young children. It occurs in about 6% to 10% of hemorrhagic colitis caused by E coli 0157:H7 and usually occurs approximately 7 to 10 days after the onset of diarrhea. Early intervention usually results in better outcomes.
Thrombotic thrombocytopenic purpura (TTP)
Persons infected with E. coli 0157:H7, particularly the elderly, can develop a syndrome similar to HUS called thrombotic thrombocytopenic purpura or TTP with clotting of blood within small blood vessels; anemia due to fragmentation of red blood cells; and a shortage of platelets (thrombocytopenia) that results in easy bruising, neurologic abnormalities, impaired kidney function, and fever. TTP is a serious consequence of E. coli 0157:H7 infection that requires early and aggressive treatment since it results in death in about 10% of all patients who develop it.
What kind of doctor(s) treat E. coli 0157:H7 infections?
People who develop only acute symptoms that are mild usually do not require a physician because the illness resolves spontaneously. However, for some children, a pediatrician may be notified and/or may want to see the child. If a person develops severe symptoms, a team of doctors that may include a nephrologist (kidney specialist), a critical care specialist (pediatric or adult), a hematologist, a pulmonologist, cardiologist, and an infectious disease specialist or even a kidney transplant surgeon may be needed. Hospitalization also may be necessary.
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