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Leard A. Mellor H. Krejany E. Chen Y. Ledger T. Boury M. Ohara M. Goffaux F. The types of E. Pathogenic E. Six pathotypes are associated with diarrhea and collectively are referred to as diarrheagenic E. Escherichia coli abbreviated as E. Although most strains of E. Some kinds of E. Still other kinds of E. It does get a bit confusing—even to microbiologists. You might hear these bacteria called verocytotoxic E.
The strain of Shiga toxin-producing E. In addition to E. Other E. First, clinical laboratories must test stool samples for the presence of Shiga toxins. Some types of STEC frequently cause severe disease, including bloody diarrhea and hemolytic uremic syndrome HUS , which is a type of kidney failure. Less is known about the non-O STEC, partly because older laboratory practices did not identify non-O infections.
As a whole, the non-O serogroups are less likely to cause severe illness than E. For example, E. People of any age can become infected. Very young children and the elderly are more likely to develop severe illness and hemolytic uremic syndrome HUS than others, but even healthy older children and young adults can become seriously ill.
The symptoms of STEC infections vary for each person but often include severe stomach cramps, diarrhea often bloody , and vomiting. Most people get better within 5—7 days. Some infections are very mild, but others are severe or even life-threatening. Clues that a person is developing HUS include decreased frequency of urination, feeling very tired, and losing pink color in cheeks and inside the lower eyelids. Persons with HUS should be hospitalized because their kidneys may stop working and they may develop other serious problems.
Most persons with HUS recover within a few weeks, but some suffer permanent damage or die. The symptoms often begin slowly with mild belly pain or non-bloody diarrhea that worsens over several days. HUS, if it occurs, develops an average 7 days after the first symptoms, when the diarrhea is improving. STEC live in the guts of ruminant animals, including cattle, goats, sheep, deer, and elk.
The major source for human illnesses is cattle. While these tools have indisputable clinical utility, questions have been raised in cases where these panels return positive for multiple pathogens [ 11 , 12 ]. Because these assays currently lack quantification, it is often unclear if treatment is indicated in cases where multiple pathogens are detected simultaneously.
Further, the proliferation of such culture-independent methods may dampen public health efforts to track outbreaks of diarrheal illness and determine antimicrobial susceptibility [ 13 ]. In conclusion, we report 3 cases of EPEC diarrhea in cancer patients. In both case 1 and case 2, azithromycin provided effective relief of diarrheal symptoms. Of note, we believe that our first patient did not experience complete resolution of her diarrhea because of the astrovirus coinfection.
In case 3, ciprofloxacin was used as per current recommendations , and the patient did experience symptomatic relief. Ultimately, azithromycin should be considered as a reasonable alternative to the fluoroquinolones in the treatment of non- Clostridium difficile watery diarrhea in adult cancer patients, especially in scenarios where the patient has had recent exposure to fluoroquinolones.
The authors declare that there are no conflicts of interest regarding the publication of this paper. All authors have participated significantly in writing of this manuscript and approve of its content. The final manuscript has been seen and approved by all authors. Denham et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Article of the Year Award: Outstanding research contributions of , as selected by our Chief Editors. Read the winning articles. Journal overview. Denham , 1 Sowmya Nanjappa , 2 and John N. Received 28 Dec Accepted 03 Apr Published 19 Apr Abstract Enteropathogenic Escherichia coli EPEC is a common cause of watery diarrhea in children in the developing world and an infrequent cause of significant diarrhea in adult patients.
Introduction Escherichia coli is the prototypical coliform bacterium: a Gram-negative, facultatively anaerobic, lactose-fermenting rod. Case Series 2. Case 1 The first patient was a year-old female with multiple myeloma status-post chemotherapy, autologous hematopoietic stem cell transplantation, and radiotherapy. Case 2 The second patient was a year-old male who was admitted to the hospital for induction chemotherapy following a recent diagnosis of acute myeloid leukemia AML.
Case 3 The third patient was a year-old male with a history significant for duodenal gastrinoma with Zollinger—Ellison syndrome who presented for evaluation due to 6 months of bouts of watery diarrhea.
Discussion The management of infections caused by E. Conflicts of Interest The authors declare that there are no conflicts of interest regarding the publication of this paper. References B. Finlay, I. Rosenshine, M. Donnenberg et al. View at: Google Scholar S. Knutton, T. Baldwin, P. Williams et al.
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