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CASE HISTORY Tammy,a Six-Year-Old Girl from Montgomery County,Pennsylvania,arrived at a Hospital's Emergency

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CASE HISTORY
Tammy,a six-year-old girl from Montgomery County,Pennsylvania,arrived at a hospital's emergency department with bloody diarrhea,a temperature of 39° C (102.2°F),abdominal cramping,and vomiting.She was admitted to the hospital five days after a kindergarten field trip to the local dairy farm.The child's health history was otherwise unremarkable.At the time of hospital admission,her parents were asked about Tammy's activities during the trip.They confirmed that Tammy bought a snack while at the farm.The laboratory reported that her fecal smear was positive for leukocytes and contained Gram-negative rods that produced shiga toxins 1 and 2.Subsequent testing of the isolate's serotype revealed E.coli O157:H7.By this time,Tammy had developed further problems.Her face and hands had become puffy,she had decreased urine output despite being given IV fluids (suggesting kidney damage),and she was beginning to develop some neurological abnormalities.Laboratory analyses of blood samples revealed thrombocytopenia (reduced blood platelet count)and confirmed hemolytic uremic syndrome (HUS,renal failure).The child was given intravenous fluid and electrolyte replacement.Antibiotics were not administered,and Tammy eventually recovered.
E.coli O157:H7 is Verotoxin-producing Escherichia coli,or EHEC.How do these differ from Enterotoxigenic Escherichia coli,or ETEC,and how would Tammy's disease progress have been observably different if she had been infected with ETEC instead?

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EHEC and ETEC differ primarily in toxin ...

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