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Research Letter |

Prevention of Hemolytic Uremic Syndrome With Daily Bowel Lavage in Patients With Shiga Toxin–Producing Enterohemorrhagic Escherichia coli O104:H4 Infection

Stefan Lüth, MD1; Thorben W. Fründt, MD1; Thomas Rösch, MD2; Christoph Schlee, MS1; Ansgar W. Lohse, MD1
[+] Author Affiliations
1Department of Medicine I, University Hospital Hamburg-Eppendorf, Hamburg, Germany
2Department of Interdisciplinary Endoscopy, University Hospital Hamburg-Eppendorf, Hamburg, Germany
JAMA Intern Med. 2014;174(6):1003-1005. doi:10.1001/jamainternmed.2014.1175.
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Infection with Shiga toxin–producing enterohemorrhagic Escherichia coli (EHEC) can cause hemorrhagic colitis and hemolytic uremic syndrome (HUS).1 An epidemic outbreak of EHEC O104:H4 started in May 2011 in northern Germany, affecting 3842 patients and causing 855 cases of HUS.2 There is little evidence in the literature that HUS can be effectively prevented. In this case-series, we present our experience of daily intestinal lavage with polyethylene glycol (PEG) for prevention of HUS in an at-risk group of patients with EHEC.

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Patient Management and Admission Procedures in All 122 Patients With Proven O104:H4 Infection Who Presented to the Outpatient Department of the University Medical Center Hamburg-Eppendorf Within the Observation Period

CRP indicates C-reactive protein; HUS, hemolytic uremic syndrome; and LDH, lactate dehydrogenase. SI conversion factors: To convert platelets and leukocytes to ×109/L, multiply by 1; lactate dehydrogenase to microkatals per liter, multiply by 0.0167; CRP to nanomoles per liter, multiply by 9.524.

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