Neurologic manifestations of E coli infection–induced hemolytic-uremic syndrome in adults

• DOI: 10.1212/wnl.0b013e31826d5f26
• Publication Date: 2012-09-20T02:59:39Z
• Authors: Karin Weissenborn; Frank Donnerstag; Jan T. Kielstein; Meike Heeren; Hans Worthmann; Hartmut Hecker; Roland Schmitt; Mario Schiffer; Thomas Pasedag; Ramona Schuppner; Anita B. Tryc; Peter Raab; Hans Hartmann; Xiaoqi Q. Ding; Carsten Hafer; Jan Menne; Bernhard M.W. Sch...; Eva Bültmann; Hermann Haller; Reinhard Dengler; Heinrich Lanfermann; Anja M. Giesemann
• Keywords: Coma (optics); Neurological examination

To describe the neurologic and neuroradiologic complications of Shiga toxin producing Escherichia coli infection (STEC)-associated hemolytic-uremic syndrome (HUS) in adults.All 52 adult patients with STEC O104:H4 cared for at Hannover Medical School during outbreak Germany through May-July 2011 are considered this observational study. Forty-three underwent a standard diagnostic procedure including clinical examination, Mini-Mental State Examination, Glasgow Coma Scale Score. Thirty-six EEG, 26 had cerebral MRI, 9 them repeatedly. Case records who not been seen by neurologist were analyzed retrospectively.Forty-eight HUS. All but 1 these showed symptoms. Focal signs like double vision, difficulties finding words, or hyperreflexia present 23, additional deficits orientation, attention, memory, constructive abilities 9, marked impairment consciousness 15. MRI brainstem, midbrain, thalamus, corpus callosum, white matter lesions half patients, predominantly diffusion-weighted images. The extent did correlate General slowing no focal alteration was found examined EEG.Our findings suggest toxic-metabolic pathology behind instead multiple infarction due to microthrombosis. Future studies should aim clarify if early antibiotic therapy bowel cleansing might help decrease rate STEC-HUS.