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Hemolytic uremic syndrome associated with group A beta-hemolytic streptococcus.

Amy B Shepherd1, April L Palmer, Steven A Bigler

  • 1Department of Pediatrics, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216-4505, USA.

Pediatric Nephrology (Berlin, Germany)
|July 2, 2003
PubMed
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Group A beta-hemolytic streptococcal (GABS) hemorrhagic colitis is rare. This case describes its association with hemolytic uremic syndrome (HUS) in a child, a link previously undocumented.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Gastroenterology

Background:

  • Group A beta-hemolytic streptococcal (GABS) infections are common, but hemorrhagic colitis is a rare manifestation.
  • Hemolytic uremic syndrome (HUS) is a serious condition, typically associated with E. coli O157:H7, characterized by hemolytic anemia, thrombocytopenia, and acute kidney injury.
  • The association between GABS hemorrhagic colitis and HUS in children has not been previously described.

Observation:

  • A 9-year-old male presented with biopsy-proven HUS.
  • The patient experienced persistent GABS-positive bloody diarrhea throughout his illness.
  • Rapid deterioration of renal function necessitated intermittent hemodialysis.

Findings:

  • This case documents the first reported instance of GABS hemorrhagic colitis associated with HUS in a pediatric patient.

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  • The patient's bloody diarrhea was confirmed to be caused by Streptococcus pyogenes.
  • Despite requiring hemodialysis, the patient showed significant renal recovery post-discharge, with residual proteinuria.

    • Implications:

    • This case expands the known spectrum of Streptococcus pyogenes-associated nephropathies.
    • It highlights the importance of considering GABS infection in children presenting with bloody diarrhea and HUS.
    • Further research is warranted to understand the pathogenic mechanisms linking GABS colitis to HUS.