Abstract
Rectal bleeding in neonates may be a symptom of necrotizing enterocolitis; however, when isolated. It is often related to ecchymotic stripes or patches on an otherwise normal rectosigmoid mucosa and has a benign evolution (DUPONT C, J Pediatr Gastroenterol Nutr 1987; 6 : 257-64). The etiology of this “ecchymotic colitis” is unknown. We report here 3 infants In which hemolytic E. Coli was found to be the cause of such a colitis.
G (♂), A & M (2 ♀) were born between 33 and 40 w of gestation, weighing 2,050 to 2,5 kg. Isolated rectal bleeding occured between d 13 and d 45. Rectosigmoidoscopy showed the caracteristic ecchymotic stripes. Clinical course was spontaneously favorable in 2; however oral feeding had to be stopped from d 24 to d 26 in M and could then be resumed without trouble.
Only an hemolytic E. Coli was isolated from cultures of mucosa of G, the histology of which showed bacteria and pneumatosis. An hemolytic E. Coli was also found in pure culture in the stools of A but not of G and H whose mucosae showed only unspecific inflammatory infiltrates. By immunoblotting, sera of the 3 infants were found to strongly recognize a major outer membrane protein of the E. Coli isolated from G and A. Sera of 3 age matched infants and of the mothers were negative. The strains isolated from G and A were negative for the known pathogenic categories of E. Coli (including E. Coli 0157:H7).
This is the first report of 1) hemolytic E. Coli being pathogenic in the GI tract, and of 2) a pathogen found responsible for ecchymotic colitis, a condition associated with rectal bleeding in infants.
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Gaillard, JL., Cheron, G., Mougenot, J. et al. 13 HEMOLYTIC E. COLI: A CAUSE OF RECTAL BLEEDING IN INFANTS. Pediatr Res 24, 407 (1988). https://doi.org/10.1203/00006450-198809000-00036
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DOI: https://doi.org/10.1203/00006450-198809000-00036