Answers:
(i) Haemolytic uraemic syndrome related to E. coli O157 enterotoxin
(ii) Potassium: life-threatening level, needs urgent treatment
(iii) None - antibiotics may trigger HUS and make the disease worse
(iv) Culture for E. coli O157 and to exclude other stool pathogens. Testing of E. coli for toxin production.
(v) He may need kidney dialysis but recovery can be expected in 90% of cases
1) A 5 year old boy who visited a farm five days previously presents with a history of bloody diarrhoea, headache and drowsiness. His urine is dark in colour and on stick-testing shows +++blood and ++protein.
Blood tests show plasma potassium 7.3 mmol/l (normal range 4-5.5); plasma creatinine 200 mmol/l (normal range 60-110).