There are five types of E. coli. Enterotoxogenic E. coli (ETEC) is the most frequent cause. By means of an enterotoxin that stimulates massive fluid secretion, patients present with cramping and explosive watery as well as bloody diarrhea that yields low-level or negative fecal leukocytes on stool testing. Because an overwhelming majority of cases of traveler’s diarrhea are due to ETEC, empiric treatment with a fluoroquinolone without bacteriologic identification of a causative organism is appropriate. Enteropathogenic E. coli is a frequent cause of childhood diarrhea lid causes watery diarrhea that is usually indistinguishable from viral infection. Enteroinvasive E. coli, which is rare in the United States, occasionally causes a dysentery-like syndrome with destruction and severe inflammation of the bowel mucosa and bloody diarrhea. More typically, the diarrhea is watery and self-limited, not requiring treatment. Enterohemorrhagic E. coli usually causes a hemorrhagic colitis without fever or significant inflammation and is associated with hemolytic uremic syndrome (HUS) and thrombocytopenic thrombotic purpura, particularly in pediatric patients. Serotype 0157:H7 is the most well known subtype. The organism is found in undercooked ground beef, and outbreaks have been linked to fast food chains, farms, and petting zoos. It is not identified with routine stool culture media; special cultures can identify the 0157:H7 subtype only. Treatment is not recommended because antibiotics do not appear helpful and may increase the incidence of complications such as HUS.*69/348/5*
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PATHOGENS OF ACUTE INFECTIOUS DIARRHEAL DISEASES: ESCHERICHIA COLI
Posted: April 12th, 2011 under Anti-Infectives.
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