April 2015 Vol. 3 No. 4

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Case Report

Clinical case of lethal ended E. Coli O-157:H7 enteritis combined with liver failure in a newborn

Pekova L.¹*, G. Yosifova¹, M. Dimitrova¹, J. Ananiev², D. Petrov³

¹Clinic of Infectious diseases, University Multiprofile Hospital for Active Treatment "Prof. d-r StoyanKirkovitch", Stara Zagora
²Department of Pathology, Medical faculty, Trakia University, Stara Zagora
³Department of Social medicine and Health management, Medical faculty, Trakia University, Stara Zagora

*Corresponding Author’s Email: pe_kova@abv.bg

Accepted April 20, 2015

Abstract

Infection with E. coli O 157 showed a wide clinical spectrum varying from hemorrhagic colitis to hemolytic-uremic syndrome and death. We present a 30-days aged patient who felt ill since 12 hours before the admittance with repeated diarrhea stool and hemorrhagic rash. In his mother, syphilis was proved. The child was admitted in a grave condition, languid and hypothermic. There was a data of heavy enteric toxicosis combined with DIC syndrome and icterus. Hemorrhagic syndrome was limited in some measure in 12 hours. Laboratorial findings showed elevated leukocytes 50.10⁹/l with left shift, hepatic cytolysis with ASAT 506 U/l., АLАТ 275 U/l, bilirubin 317 mcg/l with predominance of the conjugatedfraction and hemostatic disturbances. Microbiological investigations of feces were positive for E. coli O 157:H7 - enterohemorrhagic strain. Antibodies against Toxoplasma gondii were proved. On the second day of hospital stay edema ascites syndrome was expressed with hypoproteinemia 34 g/l and hypoalbuminemia 19 g/l. Despite of applied therapy the child finished lethally with a picture of severe liver, respiratory and cardio-vascular failure. On the autopsy advanced cirrhosis with portal hypertension, ascites, pleurisy and pericarditis as well as hemorrhagic alterations on the gastrointestinal mucosa were determined. We assumed that the diagnosis was severe hemorrhagic E. coli O-157:H7 enteritis founded on a congenital Toxoplasma gondii hepatitis with decompensated cirrhosis, conducted to DIC syndrome and edema ascites syndrome.

Keywords: Еcoli O157:H7, Hepatic cirrhosis, Newborn