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.