Enterohemorrhagic Escherichia coli Infections and the Hemolytic-Uremic Syndrome

Med Clin North Am. 2013 Jul;97(4):681-95, xi. doi: 10.1016/j.mcna.2013.04.001.


Enterohemorrhagic Escherichia coli (EHEC; Shiga toxin/verotoxin-producing E. coli) can cause bloody diarrhea and the hemolytic-uremic syndrome (HUS), typically following consumption of contaminated food (including ground beef, leafy greens, and sprouts) and water. Often associated with foodborne outbreaks, EHEC possess unique virulence factors that facilitate effective colonization of the human gastrointestinal tract and subsequent release of Shiga toxin. This article reviews the epidemiology, pathogenesis, clinical presentation, treatment, and prevention of EHEC infections, focusing on E. coli O157:H7, the serotype most common in North America, and E. coli O104:H4, the serotype responsible for the EHEC outbreak in Germany in 2011.

Publication types

  • Review

MeSH terms

  • Enterohemorrhagic Escherichia coli* / isolation & purification
  • Escherichia coli Infections* / complications
  • Escherichia coli Infections* / diagnosis
  • Escherichia coli Infections* / epidemiology
  • Escherichia coli Infections* / therapy
  • Europe / epidemiology
  • Hemolytic-Uremic Syndrome / diagnosis
  • Hemolytic-Uremic Syndrome / etiology*
  • Hemolytic-Uremic Syndrome / therapy
  • Humans
  • Primary Prevention
  • Prognosis
  • Secondary Prevention
  • United States / epidemiology