Shiga toxin E. coli

Gastrointestinal infections caused by Shiga toxin-producing Escherichia coli (STEC), of which E. coli O157:H7 is the most prominent member, pose unique diagnostic and clinical management challenges. The importance of this group of pathogens relates to their ability to cause the hemolytic uremic syndrome. Overall, STEC infections are rare, but gastroenterologists are often involved in the care of such patients because of the profound colitis that they cause. Optimal care involves awareness of the possibility that a patient with acute bloody diarrhea is infected with an STEC, access to rapid and accurate diagnostic microbiology, avoidance of interventions that might worsen the course (especially antibiotics and drugs that slow intestinal transit), strategic choices of blood tests and imaging studies, and the need for aggressive intravenous volume expansion.