Severe blood and kidney problems from E. coli infection

Severe problems affecting the blood and kidneys may develop in a small number of people (about 8%) infected with E. coli O157:H7 who get sick enough to go to the hospital.¹ These problems include anemia, a low number of platelets in the blood, the formation of small blood clots, and kidney (renal) failure.

Sometimes brain and spinal cord (central nervous system) complications also develop. Serious long-term damage to the kidneys and nervous system, as well as death, can occur.

This set of problems is known as either hemolytic uremic syndrome (HUS) or thrombotic thrombocytopenic purpura (TTP). These two conditions are now thought to be different forms of the same disease.

Symptoms

Symptoms of hemolytic uremic syndrome or thrombotic thrombocytopenic purpura may include:

• Pale skin (caused by anemia).
• Weakness or fatigue (caused by anemia).
• Passing only small amounts of urine.
• Small dark patches or dots on the skin (purpura).
• Nervous system problems. Examples include:
  • Irritability.
  • Tiredness or lack of energy.
  • Seizures.
  • Coma.
  • Inability to move one side of the body (hemiparesis).
• Long-term nervous system complications. Examples include:
  • Mental retardation.
  • Slowness of movement.
  • Blindness.

People who have been diagnosed with E. coli infection should be monitored carefully for these problems. This is especially important for children and older adults. They should have blood and urine tests rather than waiting for symptoms to develop. Monitoring should begin as soon as the diagnosis is made and continue for 2 weeks after diarrhea starts.

Risk factors

The following factors may put you at higher-than-average risk of developing blood and kidney problems from E. coli infection:

• Being treated with antibiotics
• Being younger than 5 or older than 65 years old
• Being treated with antidiarrheal medicines
• Having bloody diarrhea
• Having a high white blood cell count
• Having a high fever

Citations

1. Centers for Disease Control and Prevention (2008). Escherichia coli. Available online: http://www.cdc.gov/nczved/dfbmd/disease_listing/stec_gi.html.