A Case of Colitis Caused by Enterohemorrhagic Escherichia Coli O-157: H7, Requiring Surgery for Concomitant Peritonitis

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 22; no. 6; pp. 979 - 983
• Main Authors: Hoashi, Takaya, Iwase, Kazuhiro, Higaki, Jun, Yoon, H.E, Mikata, Shoki, Miyazaki, Makoto, Nishitani, Akiko, Kawamoto, Koichi, Oimatsu, Natsumi, Kin, Keiwa, Imakita, Masami, Kamiike, Wataru
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society for Abdominal Emergency Medicine 2002
• Subjects: Verotoxin
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem1993.22.979

We report a case of colitis caused by enterohemorrhagic Escherichia coli (EHEC) O-157: H7 requiring emergency surgery for concomitant peritonitis. A 61-year-old woman admitted for diarrhea, abdominal pain and hematemesis on September, 2001 was found in abdominal computed tomography (CT) to have edematous changes in the ascending colon. Supportive therapy was ineffective. CT 3 days after admission showed edematous changes had expanded in the colon and massive ascites and pleural effusion occurred, necessitating emergency right hemicolectomy for progressive peritonitis. The postoperative course was uneventful. Serological bacterial agglutination assay (BA) antibody titers to O-157 antigen was positive 3 days after admission, whereas fecal culture at admission and after surgery showed no abnormality. Caution should therefore be paid to possible rapid O-157 colitis progress without abnormality in fecal cultures.