Shiga toxin producing E. coli (STEC) may cause severe hemorrhagic colitis followed by hemolytic uremic syndrome (HUS). In Korea, there had been a few case reports of HUS by STEC, mostly due to O157 serotype. The reports of HUS caused by STEC non-O157 serotype were rare. We report a sporadic case of HUS associated with hemorrhagic colitis. A 51-year-old woman was admitted to our hospital due to intractable abdominal pain and bloody diarrhea. Three days after admission, azotemia and microangiopathic hemolysis developed. E. coli, serotype O111 was identified. Conservative management with plasmapheresis resulted in a complete recovery.
Colitis/complications/*microbiology ; Escherichia coli/*classification ; Escherichia coli Infections/complications/*microbiology ; Female ; Gastrointestinal Hemorrhage/*etiology ; Hemolytic-Uremic Syndrome/complications/*microbiology ; Humans ; Middle Aged ; Serotyping

Although Pseudomonas aeruginosa is not generally considered as a cause of antibiotic-associated diarrhea, several cases of diarrhea caused by P. aeruginosa have been reported. We experienced seven cases of nosocomial diarrhea presumably caused by P. aeruginosa, which was the predominant organism isolated from stool cultures. Clostridium difficile toxin was also positive in one patient. No other potential or recognized enteropathogens were identified from stools. All patients had underlying diseases and had been receiving antibiotics before the diarrheal onset. All of the seven P. aeruginosa isolates were resistant to previously given antibiotics. Diarrhea stopped three days after withdrawal of probable offending antibiotics without specific treatment in two patients. The other five patients having continuous diarrhea despite withdrawal of probable offending antibiotics, were successfully treated with antipseudomonal agents. The median duration of diarrhea after the initiation of treatment was 6.3 days. These data suggest that P. aeruginosa can be a potential cause of antibiotic-associated diarrhea. Further investigations are warranted to evaluate the possible etiologic role of P. aeruginosa in antibiotic-associated diarrhea.
Adult ; Aged ; Antibiotics/*adverse effects ; Colitis/complications/drug therapy ; Cross Infection/complications ; Diarrhea/*chemically induced/*microbiology ; Feces/microbiology ; Female ; Human ; Male ; Middle Age ; Pseudomonas Infections/*complications ; *Pseudomonas aeruginosa ; Retrospective Studies