PT - JOURNAL ARTICLE AU - James Kennedy AU - Lauren Simmonds AU - Robert Orme AU - Warren Doherty TI - An unusual case of <em>Escherichia coli</em> O157:H7 infection with pseudomembranous colitis-like lesions associated with haemolytic-uraemic syndrome and neurological sequelae AID - 10.1136/bcr-2016-218586 DP - 2017 Jun 17 TA - BMJ Case Reports PG - bcr-2016-218586 VI - 2017 4099 - http://casereports.bmj.com/content/2017/bcr-2016-218586.short 4100 - http://casereports.bmj.com/content/2017/bcr-2016-218586.full AB - A 75-year-old man was admitted with abdominal pain and fresh rectal bleeding. Significantly, he had no risk factors for Clostridium difficile infection. An abdominal CT demonstrated colonic thickening, and flexible sigmoidoscopy identified pseudomembranous colitis-like lesions. After initial treatment as C. difficile colitis, a stool sample revealed Escherichia coli O157:H7 infection. Antibiotic therapy was stopped due to the risk of lysis-mediated toxin release, but unfortunately, the patient continued to deteriorate. He developed several of the severe sequelae of E. coli O157:H7 infection, including haemolytic-uraemic syndrome with an acute kidney injury necessitating haemofiltration, plus progressively severe seizures requiring escalating antiepileptic treatment and intubation for airway protection. After a prolonged intensive care admission and subsequent recovery on the ward, our patient was discharged alive.