CLOSTRIDIUM-SEPTICUM SEPSIS AND MENINGITIS AS A COMPLICATION OF THE HEMOLYTIC-UREMIC SYNDROME

Hemolytic-uremic syndrome (HUS) is recognized by the triad of acute microangiopathic hemolytic anemia, thrombocytopenia, and oliguric renal failure. The condition is usually preceded by gastroenteritis associated with bloody diarrhea. Escherichia coli 0157:H7, an enterohemorrhagic verotoxin producing E. coli, is now recognized as the most common pathogen associated with hemorrhagic colitis and HUS in North America.1 Since its description, a variety of gastrointestinal and neurologic complications of HUS have been noted. An association between HUS and meningitis due to Hemophilus influenzae 2 and Streptococcus pneumoniae3 has been previously reported. In addition, the first reported case of Clostridium septicum sepsis and cerebritis complicating gastrointestinal involvement in HUS was reported in 1988.4 We report the second confirmed case of fatal C. septicum sepsis and meningitis as a complication of HUS, suggesting that this entity may be more common than previously recognized. We review the epidemiology and clinical manifestations of C. septicum infections and speculate on the pathogenesis of the colitis and invasive C. septicum infection in our patient. © 1993, Sage Publications. All rights reserved.