What do petting zoos, river swimming, and hamburgers have in common? All have been linked with the spread of Shiga-toxin producing E. coli or STEC O157:H7, which is a strain linked with hemolytic uremic syndrome (HUS).  

This episode was written by pediatricians Lidia Park and Tammy Yau with content support from Stephanie Nguyen (UC Davis pediatric nephrology). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.  

Key Points: 

• Hemolytic uremic syndrome is a microangiopathic hemolytic anemia caused by Shiga toxin producing E. coli. 
• Symptoms include anemia, thrombocytopenia, and uremia 
• Treat HUS with hydration (but not too much as that can lead to fluid overload), blood transfusion if needed for severe anemia, and close monitoring as some patients progress to needing dialysis 

Sources: 

• Peds in Review, 2020. Pediatr Rev (2020) 41 (4): 213–215. https://doi.org/10.1542/pir.2018-0346 
• AAP Grand Rounds (2023) 49 (5): 55. https://doi.org/10.1542/gr.49-5-55 
• AAP Grand Rounds (2024) 52 (1): 6.https://doi.org/10.1542/gr.52-1-06 
• Ho, Erin.  “Factors associated with Actionable Gastrointestinal Panel Results in Hospitalized Children”.  Hospital Pediatrics Nov 2023