A 5-year-old boy is brought to the emergency department with worsening lethargy for 3 days. Six days ago, he experienced abdominal pain, vomiting, and bloody diarrhea that have since resolved. His temperature is 38.8°C (101.8°F), pulse is 128/min, respirations are 30/min, and blood pressure is 96/60 mm Hg. Examination shows pale conjunctivae and scleral icterus. Physical examination shows pallor but is otherwise normal. He has no peripheral edema or rashes. Laboratory evaluation shows anemia, thrombocytopenia, and elevated blood urea nitrogen and serum creatinine. Peripheral blood smear shows fragmented erythrocytes. This patient's condition is most likely related to consumption of which of the following foods?

Question

A 5-year-old boy is brought to the emergency department with worsening lethargy for 3 days. Six days ago, he experienced abdominal pain, vomiting, and bloody diarrhea that have since resolved. His temperature is 38.8°C (101.8°F), pulse is 128/min, respirations are 30/min, and blood pressure is 96/60 mm Hg. Examination shows pale conjunctivae and scleral icterus. Physical examination shows pallor but is otherwise normal.  He has no peripheral edema or rashes. Laboratory evaluation shows anemia, thrombocytopenia, and elevated blood urea nitrogen and serum creatinine.  Peripheral blood smear shows fragmented erythrocytes.  This patient's condition is most likely related to consumption of which of the following foods?

Quizplus · Accepted Answer

Eductional Objective: Enterohemorrhagic Escherichia coli (EHEC) is primarily contracted after eating undercooked ground beef.  EHEC produces Shiga toxin, which causes hemorrhagic colitis and can lead to hemolytic-uremic syndrome (HUS).  HUS is characterized by acute renal failure, thrombocytopenia, and microangiopathic hemolytic anemia; children age <10 are at greatest risk.

A 5-Year-Old Boy Is Brought to the Emergency Department with Worsening