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The first 300 words of the full text of this section appear below.

Section 3. Summaries of Infectious Diseases

Escherichia coli Diarrhea

(Including Hemolytic-Uremic Syndrome)

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

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CLINICAL MANIFESTATIONS

At least 5 pathotypes of diarrhea-producing Escherichia coli strains have been identified. Clinical features of disease caused by each pathotype are summarized as follows (also see Table 3.5, p 295):


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  		Table 3.5. Classification of Escherichia coli Associated With Diarrhea

  • Shiga toxin-producing E coli (STEC) organisms are associated with diarrhea, hemorrhagic colitis, hemolytic-uremic syndrome (HUS), and postdiarrheal thrombotic thrombocytopenic purpura (TTP). STEC O157:H7 is the prototype and the most virulent member of this E coli pathotype. Illness caused by STEC often begins as nonbloody diarrhea but usually progresses to diarrhea with visible or occult blood. Severe abdominal pain is typical; fever occurs in less than one third of cases. Severe infection can result in hemorrhagic colitis.

  • Diarrhea caused by enteropathogenic E coli (EPEC) is watery and often is severe enough to result in dehydration and even death. Illness occurs almost exclusively in children younger than 2 years of age and predominantly in resource-limited countries, either sporadically or in epidemics. Chronic EPEC diarrhea can result in growth retardation.

  • Diarrhea caused by enterotoxigenic E coli (ETEC) is a 1- to 5-day self-limited illness of moderate severity, typically with watery stools and abdominal cramps. ETEC is common in infants in resource-limited countries and in travelers to those countries but is uncommon as a cause of diarrhea in the United States.

  • Diarrhea caused by enteroinvasive E coli (EIEC) is similar clinically to diarrhea caused by Shigella species. Although dysentery can occur, diarrhea usually is watery without blood or mucus. Patients often are febrile, and stools may contain leukocytes.

  • Enteroaggregative E coli (EAEC) organisms cause watery . . . [Go to Full Text]


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