E. coli, Antibiotics, and the Hemolytic–Uremic Syndrome

The hemolytic–uremic syndrome is characterized by hemolytic anemia, thrombocytopenia, and acute renal insufficiency. There are at least four major causes of the syndrome: bacterial and viral infections, which are responsible for the epidemic form; hereditary factors, which are responsible for familial forms, in particular recurrent, or atypical, hemolytic–uremic syndrome; systemic conditions, such as systemic lupus erythematosus, cancer, transplant rejection, glomerulonephritis, and pregnancy; and exposure to toxins or potential toxins, such as cyclosporine, tacrolimus, mitomycin, and radiation.¹ Among children the chief cause of the hemolytic–uremic syndrome is infection with enterohemorrhagic strains of Escherichia coli. Originally, a variety of serotypes were described . . .