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Published on: August 19, 2016
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
Summary
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.
- 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.
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