Table 1: Review of reported cases of HUS with concomitant C. septicum infection.

Patient Presentation Exposure Diagnostic culture Antibiotic/HD/surgery Outcome Reference
5 y/F Fever, abdominal pain, emesis, weight loss, T1DM in DKA No known exposure Blood Piperacillin-tazobactam, Ampicillin, Fluconazole x 21 days/HD/+ sigmoid colectomy, colon resection, ostomy placement Survived, discharged hospital day 80 Iddings AC, et al. [4]
3 y/F Fever, bloody diarrhea, abdominal pain, neurologic deterioration Cattle farm Brain, colon biopsy None Death at 36 hours of admission Engen RM, et al. [5]
4 y/F Fever, bloody diarrhea, abdominal pain Petting zoo Blood culture Metronidazole 4 mg/kg q6h, Clindamycin 10 mg/kg q8h, Meropenem 20 mg/kg q24h x 14 days/HD/- Survived, discharged hospital day 19 Engen RM, et al. [5]
6 y/F Fever, bloody diarrhea, abdominal pain, irritability No known exposure Blood culture Penicillin G 20, 000 U/kg IV q6h x 7 days/HD/- Survived, discharged hospital day 21 Engen RM, et al. [5]
2 y/M Bloody diarrhea, lethargy, pallor, oliguria Dairy farm Brain biopsy, cranial burr hole drain culture Meropenem, Metronidazole, Clindamycin, Linezolid x several months/HD/+ craniectomy Survived, repeat MRI day +462 with no residual abscess Williams EJ, et al. [6]
2 y/M Bloody diarrhea, anuria, acute respiratory failure Unknown Blood culture, brain, lung, kidney, liver, bowel autopsy None Death at 14 hours of admission Martin SE, et al. [7]
19 m/M Bloody diarrhea, anuria, facial and leg edema, R arm ecchymosis No known exposure R arm wound culture Penicillin, Clindamycin x 14 days/-/+ amputation Survived, discharged at hospital day 22 Hunley TE, et al. [2]
2 y/M Bloody diarrhea, vomiting, fever, petechial rash, fasciitis Unknown Blood culture Cefuroxime, metronidazole/PD/- Death at 8 hours of admission Barnham M, et al. [8]
2 y/M Bloody diarrhea, emesis, abdominal cramping, lethargy Unknown Brain abscess culture Penicillin, Metronidazole x 6 weeks/HD/+ craniotomy Survived Chiang V, et al. [9]
2 y/F Bloody diarrhea, fever, vomiting, L sided focal seizure, acute neurologic demise Unknown CSF and blood cultures, autopsy of colon Penicillin 75,000 U/kg, Metronidazole 7.5 mg/kg/-/+ emergent ventriculostomy Death at 6 hours of admission Broughton RA, et al. [10]
4 y/M Bloody diarrhea, abdominal pain, seizures, acute neurologic demise Unknown Brain autopsy None/PD/- Death at ~50 hours of admission Randall JM, et al. [11]
16 m/M Bloody diarrhea, fever, seizures, abdominal rash, acute neurologic demise Unknown Skin culture, post-mortem blood culture, brain and colon autopsy Ampicillin, clindamycin, gentamicin/-/- Death at 2 days of admission Riccio J, et al. [12]

HD: Hemodialysis; PD: Peritoneal dialysis; T1DM: Type 1 diabetes mellitus; DKA: Diabetic ketoacidosis.