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)

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Comment from: pf, 55-64 Female (Patient) Published: March 06

My E. coli infection started out with gurgling in stomach, turned into stomach cramps, diarrhea, and within 24 hours turned into bloody urine/stools. I went to Urgent Care then to emergency room (because it was Sunday). The hospital did tests, but not stool culture, put me on antibiotics; it got worse and I had two ports inserted, scans, diverticulitis and colitis ruled out. Fourth day in ICU/isolation determined HUS (hemolytic uremic syndrome). I was started on feeding tube and plasmapheresis was added for 10 days. I had lots of headaches, shivering and vomiting, jaundiced skin color and hallucinations. I was off work 5 weeks with very little energy or ability to walk. I had reaction to flu vaccination with more diarrhea and vomiting. I lost 17 lbs on a 130 lb. frame. Eighteen months later, I have my weight back but still don"t have 100% energy and as a runner, my time has decreased from 8 minutes/mile to 11 minutes. My legs just won"t carry me. CBC is normal.

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Comment from: Mtntrek, 55-64 Male (Patient) Published: April 11

My background is I am type 1.5 diabetic, on insulin. I was diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP) after initial Guillain Barre syndrome (GBS). I had very sudden onset of urgent watery diarrhea coupled with my gastrointestinal neuropathy has had me in diapers over a month. There is pronounced sloshing in gut in between violent evacuations. With total loss of control while asleep, I"ve not slept in a bed or over 2 hours at a time in that period of time. I had very little pain and no vomiting. Usual hormone fluctuations, chills and sweats, although fever not noted. I lost 10% (18 lbs) weight. Total exhaustion has resulted in little exercise. There was CIDP symptom resurgence after a year in remission since last IVIG infusion. High glycemic BRAT diet is a far cry from my normal diabetes high fiber low carb diet, but it slowed frequency and volatility of purge cycles. No doubt next A1C could be less than optimal. Very humbling experience indeed.

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