Sporadic cases of haemolytic-uraemic syndrome associated with faecal cytotoxin and cytotoxin-producing Escherichia coli in stools

Lancet. 1983 Mar 19;1(8325):619-20. doi: 10.1016/s0140-6736(83)91795-6.


A cytotoxin active on Vero cells, less active on hela cells, and inactive on WI38 cells (Vero toxin [VT]) was detected in stool isolates of Escherichia coli from 8 of 15 sporadic cases of haemolytic uraemic syndrome (HUS). Stools from 5 of these 8 patients were examined for faecal VT activity, and all were positive. Of the 7 of 15 patients who did not have VT+ E. coli, 2 were positive for faecal VT, and a third (patient K) had strong serological evidence of VT+ E. coli infection. 2 HUS patients, including patient F, had siblings with uncomplicated diarrhoea who had both VT+ E. coli in the stools and faecal VT activity. Thus 11 of 15 (73%) of the HUS cases had evidence of infection by VT+ E. coli, suggesting that there was an association between these organisms and these cases of HUS. The clustering of 2 HUS patients and their siblings with VT+ E. coli accords with this suggestion, as do the rising titres of VT-neutralising antibody in 2 HUS patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies / analysis
  • Child
  • Child, Preschool
  • Cytotoxins / biosynthesis*
  • Cytotoxins / immunology
  • Diarrhea, Infantile / etiology
  • Diarrhea, Infantile / microbiology
  • Escherichia coli / classification
  • Escherichia coli / isolation & purification
  • Escherichia coli / metabolism*
  • Escherichia coli Infections* / microbiology
  • Feces / microbiology*
  • Female
  • Hemolytic-Uremic Syndrome / etiology*
  • Hemolytic-Uremic Syndrome / microbiology
  • Humans
  • Infant
  • Male
  • Serotyping


  • Antibodies
  • Cytotoxins