A 4-year-old boy gives the history of bloody diarrhea and now hospitalized for oliguria and hypeension. With which organism is he most likely infected?: (A) Clostridium perfringens, (B) Salmonella typhi, (C) Enteroinvasive E. coli, (D) Shiga toxin-producing E. coli
Answer is D. The case is descriptive of hemolytic uremic syndrome associated with infection with E. coli O157:H7. This strain of E. coli produces phage-associated Shiga toxins (Stx-1 and/or Stx-2) that are functionally and antigenically similar to that produced by Shigella dysenteriae. None of the other organisms listed are associated with hemolytic uremic syndrome, although some do cause a bloody diarrhea. C. perfringens causes watery diarrhea.