HE JAPANESE JOURNAL OF ANTIBIOTICS 50-11 861 (7) PREDICTIVE FACTORS FOR DEVELOPMENT OF HEMOLYTIC UREMIC SYNDROME(HUS)AND EARLY INTENSIVE TREATMENTS FOR PREVENTATION OF HUS IN ENTEROHEMORRHAGIC ESCHERICHIA COLI INFECTION

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  • 腸管出血性大腸菌感染症における溶血性尿毒症症候群 (HUS) 合併の予期因子と合併予防のための早期集約的治療について

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Predictive factors for the development of hemolytic uremic syndrome (HUS) were evaluated in 88 inpatients who suffered from enterohemorrhagic E. coli infections in the outbreak in Sakai, 1996. All in- and outpatients received oral or intravenous fosfomycin within acute phase of hemorrhagic colitis, and HUS complicated 1.4% of them. Persistence of bloody stools and dirrhea were longer in HUS patients than in non-HUS patients, but persistence of abdominal pain was not different in either group. Leukocytosis with leukocyte counts over 15,000/αl and/or elevated CRP level over 2.0mg/dl at admission, and fever and/or vomiting in the course of hemorrhagic colitis were more frequent in HUS patients than in non-HUS patients. Early intensive treatments including gamma-globlin, urinastatin, aspirin, and dipyridamole were employed in 34 high risk patients for prevention of HUS. These patients were estimated to be at risk of developing HUS because of incomplete HUS, nephropathy, elevated LDH level, thrombocytopenia, or age younger than two years old. These treatments were clinically effective.

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