Male with Hemolytic-Uremic Syndrome O128ab:H2 Bacteremia in a 27-Year-Old Verocytotoxin-Producing Escherichia coli

n May 2010, a 27-year-old male was admitted to the emergencyroom 4 days after onset of diarrhea, vomiting, and abdominalpain. He had no other recent medical history and had not takenany medication during the prior 3 months. Physical examinationrevealed that the patient was icteric but afebrile. Palpation of theabdomen was painful in the lower-right quadrant, and a com-putedtomographyscanrevealedlocalizedperitonitissecondarytoa perforated appendicitis. Empirical antimicrobial therapy withintravenousceftriaxone(2gdaily)andmetronidazole(1.5gdaily)was initiated. Surgical resection of the necrotic appendix and gen-erous rinsing of the peritoneal cavity were performed by laparot-omy. Direct examination and culture of the peritoneal liquid col-lected per-operatively remained negative.Blood and biochemical tests revealed a white blood cell countof 10,100/mm