E. coli HUS Symptoms

Hemolytic uremic syndrome (HUS) is most commonly a complication of E. coli O157:H7  foodborne illness infections, but it can also develop in patients who are infected with other foodborne pathogens such as Shigella¹ or Salmonella². Infection with other strains of E. coli bacteria can also lead to HUS.

HUS is known for causing a constellation of three problems: hemolytic anemia (a low blood cell count), thrombocytopenia (a low blood platelet count), and kidney damage.³ Hemolytic anemia, for example, can produce paleness, weakness, or even jaundice (yellowing of the skin). Thrombocytopenia causes problems with blood clotting that can lead to bruises and a type of skin rash called petechiae. Kidney damage creates a host of issues, including impaired urination and high blood pressure.

The symptoms of HUS also evolve based on the organs of the body that sustain damage from Shiga toxins and the resulting microscopic platelet clumps that can occlude the smallest blood vessels. The kidneys take the brunt of the damage, but HUS can damage other organs such as the brain or pancreas.⁴

Early HUS symptoms

In patients who have E. coli O157:H7 infections, symptoms of HUS usually begin 5 to 10 days after diarrhea starts.⁵ Early symptoms can include:

• Abdominal cramps
• Diarrhea that becomes bloody
• Fever
• Irritability
• Vomiting³

Later HUS symptoms

As the disease progresses, symptoms may consist of the following:

• Pale skin (from hemolytic anemia)
• Fatigue
• Small unexplained bruises or bleeding (from blood clotting impairment)
• Reduced urine output that may appear red (a sign of kidney failure)
• No urine output
• High blood pressure
• Skin rash resembling tiny red spots (petechiae)
• Jaundice (a yellowish skin color)
• Swelling of face, hands, feet, or entire body.⁶

Neurologic symptoms are more rare, but can include:

• Dizziness
• Seizures (partial or generalized)
• Disorientation or confusion
• Loss of consciousness (coma)⁷

In adults, HUS is more complicated. The condition often resembles–and some experts say overlaps–a condition known as thrombotic thrombocytopenic purpura (TPP).⁸

Contact your doctor if you or someone you know has any of these HUS symptoms. Reduced consciousness, blood in the stool, or urination problems signals an emergency situation.

Pritzker Olsen, a leading food safety law firm, has gained a national reputation in the area of E. coli litigation. To contact the firm, please call toll-free at 1-888-377-8900 or submit the firm’s online free case consultation.

References:
1. Moake JL. Haemolytic-uraemic syndrome: basic science. Lancet 1994;343(8894)393-7

2. Flores FX, Jabs K, Thorne GM, et al. Immune response to Escherichia coli O157:H7 in hemolytic uremic syndrome following salmonellosis. Ped Nephrol 1997;11(4):488-90

3. Ruggenenti P, Noris M, Remuzzi G. Thrombotic microangiopathy, hemolytic uremic syndrome, and thrombotic thrombocytopenic purpura. Kidney Int 2001;60(3):831-46

4. Chandler WL, Jelacic S, Boster DR, et al. Prothrombotic coagulation abnormalities preceding the hemolytic-uremic syndrome. N Engl J Med 2002;346(1):23-32

5. American Academy of Family Physicians. Hemolytic uremic syndrome. Available at http://familydoctor.org/online/famdocen/home/common/kidney/905.html. Accessed Dec. 13, 2007

6. National Institute of Diabetes and Digestive and Kidney Diseases. Hemolytic uremic syndrome. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/childkidneydiseases/hemolytic_uremic_syndrome/. Accessed Dec 13, 2007

7. WebMD. Hemolytic uremic syndrome. Available at http://children.webmd.com/hemolytic-uremic-syndrome. Accessed Dec. 13, 2007

8. MedLine Plus Medical Encyclopedia. Hemolytic-uremic syndrome. Available at http://www.nlm.nih.gov/medlineplus/ency/article/000510.htm. Accessed Dec. 13, 2007