Hemolytic uremic syndrome: just another case of gastroenteritis?

Hemolytic uremic syndrome (HUS), the most common cause of acute renal failure in childhood, has the potential to progress to a life-threatening illness. Its incidence in North America is increasing. Several studies have shown that Escherichia coli O157:H7 is associated with HUS. Although this pathogen was first recognized more than 10 years ago and is relatively common, many physicians are not aware of this diagnosis let alone the spectrum of illness associated with the bacteria. This case exemplifies what appears initially as gastroenteritis but, ultimately, becomes the final diagnosis of HUS. A case is presented to provide additional education to ensure the E coli O157:H7 infection is considered in the differential diagnosis of persons who present with bloody diarrhea.