A 4-year-old girl is brought to the physician because of a rash and malaise for the past 2 days. She had a 4-day history of diarrhea that subsided two days ago. One month ago, she had a 3-day episode of high fever, followed by a rash with bright red discoloration over her cheeks for two days before subsiding without treatment. Her vaccinations are up-to-date. She is alert and oriented. Her vital signs are within normal limits. Examination shows petechiae on her trunk and extremities. Abdominal examination shows diffuse abdominal tenderness with hyperactive bowel sounds. Laboratory studies are as follows: Urinalysis shows proteinuria and hematuria. Which of the following mechanisms is the most likely cause of this patient's condition?

Question

A 4-year-old girl is brought to the physician because of a rash and malaise for the past 2 days. She had a 4-day history of diarrhea that subsided two days ago. One month ago, she had a 3-day episode of high fever, followed by a rash with bright red discoloration over her cheeks for two days before subsiding without treatment. Her vaccinations are up-to-date. She is alert and oriented. Her vital signs are within normal limits. Examination shows petechiae on her trunk and extremities. Abdominal examination shows diffuse abdominal tenderness with hyperactive bowel sounds. Laboratory studies are as follows:  Urinalysis shows proteinuria and hematuria.  Which of the following mechanisms is the most likely cause of this patient's condition?

Quizplus · Accepted Answer

Eductional Objective: Hemolytic uremic syndrome is a common cause of acute renal failure in children.  It is characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury.  Most cases develop following a diarrheal illness caused by Shiga toxin-producing organisms (eg, Escherichia coli O157:H7, Shigella dysenteriae).

A 4-Year-Old Girl Is Brought to the Physician Because of a Rash