1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-7-42-a 10.15844/pedneurbriefs-7-6-2 Infectious Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant E Coli Hemorrhagic Colitis and Neurologic Symptoms http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 06 1993 01 07 2016 7 6 42 42 Copyright: © 1993 The Author(s) 1993 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Neurological manifestations of hemorrhagic colitis in the outbreak of Escherichia coli O157:H7 infection in Japan

The neurological manifestations of hemorrhagic colitis in seven kindergarten children with Escherichia coli 0157:H7 infection are reported from the Saitama Children’s Medical Center, Saitama, Japan.

 Hemorrhagic Colitis Phrenic Nerve Paralysis Hemolytic Uremic Syndrome

The neurological manifestations of hemorrhagic colitis in seven kindergarten children with Escherichia coli 0157:H7 infection are reported from the Saitama Children’s Medical Center, Saitama, Japan. Generalized convulsions, occurring in 5 comatose patients, were intractable in 3 and required toxic doses of anticonvulsants for their control. Two patients died after 5 and 7 days of illness. Transient symptoms, delayed in onset for 2 to 6 weeks and after consciousness improved, included phrenic nerve paralysis in 1 patient, neurogenic urinary incontinence in 3, gaze nystagmus in 3, action tremor and oral dyskinesia in 1, and vertigo in 1 patient. Pyrexia and hemolytic uremic syndrome were seen only in patients with neurologic complications. Diarrhea, bloody diarrhea, and abdominal pain were more frequent and severe in this group compared to 7 patients with no neurologic symptoms who were admitted to hospital. Contaminated well water was the source of infection, and verotoxin-I (Shiga-like toxin I) was the likely cause of neurological symptoms. [1]

COMMENT. Fever, high white blood cell count, young or old age, and prolonged antimotility drug use are risk factors for complications of this strain of E. coli infection. The neurologic and other complications of foodborne and waterborne infections, pollutants, and additives, are covered in Environmental Poisons in Our Food, Chicago, PNB Publishers.

 Hamano S Nakanishi Y Nara T Seki T Ohtani T Oishi T Neurological manifestations of hemorrhagic colitis in the outbreak of Escherichia coli O157:H7 infection in Japan Acta Paediatr 1993 May 82 5 454 8 8518521 10.1111/j.1651-2227.1993.tb12721.x