E. Coli - Symptoms

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What are the symptoms of E. coli 0157:H7 infections?

Initial symptoms of E. coli O157:H7 infection

The initial symptoms of E. coli O157:H7 infection usually appear about three to five (though occasionally in as few as one day or as many as 10 days) after a person ingests the bacteria; the symptoms include

  • nausea,
  • vomiting,
  • stomach cramps, and
  • diarrhea that often is bloody.

The person may have a mild fever of about 100 to 101F (37.7 to 38.3 C). These symptoms can be seen in infected children and adults.

Later symptoms E. coli O157:H7 infections

The majority of people (especially normal adults) are infected resolve the infection without antibiotics in about five to seven days. However, some people (about 10% of people infected, especially children under the age of 5 and the elderly) develop more severe signs and symptoms, and these people usually require hospitalization and aggressive treatment. These patients develop the usual symptoms listed above, but do not resolve the infection. They develop symptoms that last longer (at least a week) and, if not treated promptly, the infection may lead to disability or death.

These symptoms or complications fall into three main categories;

  • Hemorrhagic (bloody) diarrhea: Hemorrhagic (bloody) diarrhea symptoms are an increased amount of blood in the diarrheal stool that does not seem to resolve and is usually accompanied by severe abdominal pain. Although this may resolve within a week, some individuals can develop anemia and dehydration that can cause death.
  • Hemolytic-uremic syndrome (HUS): Hemolytic-uremic syndrome symptoms of pallor (due to anemia), fever, bruising or nosebleeds (due to destruction of blood platelets that are needed for blood to clot), fatigue, shortness of breath, swelling of the body, especially hands and feet, jaundice, and reduced flow of urine may be seen. HUS symptoms usually develop about 7 to 10 days after the initial diarrhea begins. HUS is the most common cause of kidney failure in children; children under 10 years old are the most likely to develop HUS. E. coli 0157:H7 produces toxins that damage the kidneys and destroys platelets that can lead to kidney failure, excessive bleeding, seizures or death.
  • Thrombotic thrombocytopenic purpura (TTP): Thrombotic thrombocytopenic purpura is caused by the loss of platelets; however, the symptoms that occur are somewhat different and occur mainly in the elderly. The symptoms are fever, weakness, easy, rapid or "spontaneous" bruising, renal failure, and mental impairment that can rapidly progress to organ failures and death. Until the 1980's, TTP was considered a fatal disease, but since the 1980's, plasma exchange and infusion techniques have reduced the death rate in TTP patients to about 10%.

For most people (about 90%), the E. coli infection clears and a good outcome or prognosis occurs. However, if any of the above mentioned complications happen, the prognosis may range from good to poor. The variable prognosis depends on the severity of the complication, the quickness of diagnosis and treatment, the response of the individual to adequate treatment and the overall health of the individual. Children and the elderly are at higher risk for adverse outcomes.

Return to E. coli (0157:H7)

See what others are saying

Comment from: bob, 19-24 Male (Patient) Published: September 29

Two month ago I started having a cold-like sore throat and then the next day I had excessive flatulence and went to the bathroom and I had diarrhea. I did not have any abdominal pain, nausea, or vomiting but I had the urge to go. At night I woke up feeling hot with a headache. I checked my temperature and it was 100.4. I took Tylenol and I felt better but the next day my diarrhea got worse with blood and I visited the bathroom like 20 times. When bedtime came I slept but I woke up at midnight with severe headache, fatigue, and my fever was 103.5. I went to the emergency room (ER) and they gave me IV fluids antibiotics and I was diagnosed with E. coli. I feared that it was meningitis or typhoid.

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Comment from: susan H., 75 or over Female (Patient) Published: June 30

I was just discharged from the hospital with a diagnosis of E. coli. It took 4 days to grow a culture (from blood) and get the results because my only symptoms were mild (100 degrees) fever, severe chills and shaking, and inability to catch my breath. No urinary tract symptoms, no stomach cramps, no diarrhea. I've not heard of these symptoms in any article or information article.

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