A 67-year-old woman with vomiting, bloody diarrhea, and azotemia

A 67-year-old woman was admitted to a hospital because of nausea, vomiting and bloody diarrhea. She had been vacationing in Europe, where she developed symptoms one day after eating chicken. She was anemic and blood tests revealed that she had acute kidney failure. She was diagnosed with hemolytic-uremic syndrome, which in adults is often caused by E. coli strain O157:H7. A renal biopsy confirmed the diagnosis of kidney failure. She responded to dialysis, plasma exchange and corticosteroids. A stool sample was negative but blood samples sent to the CDC tested positive for E. coli O157:H7.