Escherichia Coli Infections Follow-up

  • Author: Tarun Madappa, MD, MPH; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Nov 15, 2011
 

Further Inpatient Care

The following are indicated:

  • Supportive and symptomatic care
  • Adequate hydration and oxygenation
  • Periodic neurological test for meningitis
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Further Outpatient Care

Supportive care and rehabilitation should be provided to persons with meningitis who develop neurologic sequelae.

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Inpatient & Outpatient Medications

Most severe E coli infections warrant hospitalization. These include meningitis, pneumonia, cholecystitis/cholangitis, intra-abdominal abscess, and some cases of complicated UTI and pyelonephritis.

In patients with pyelonephritis, a switch to oral medications should be made as soon as the patient is able to tolerate oral intake.

The duration of therapy depends on the type of infection.

In case of enterohemorrhagic E coli (EHEC) diarrhea, antibiotics are contraindicated and treatment is supportive and symptomatic in nature.

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Complications

HUS may complicate EHEC infection. E coli meningitis in neonates usually results in neurological sequelae.

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Prognosis

The prognosis depends on the specific diagnosis; therefore, no generalizations can be made.

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Patient Education

Patients should be instructed on personal hygiene, such as washing hands and improving food preparation techniques.

When traveling to endemic areas, drink bottled water.

Prophylactic antibiotics may be administered for as long as 3 weeks for travelers in developing countries in whom the risk and benefits have been discussed.

Advise patients to cook meat properly to prevent hemorrhagic colitis and HUS.

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Contributor Information and Disclosures
Author

Tarun Madappa, MD, MPH  Attending Physician, Department of Pulmonary and Critical Care Medicine, Elkhart General Hospital

Tarun Madappa, MD, MPH is a member of the following medical societies: American College of Chest Physicians and American Thoracic Society

Disclosure: Nothing to disclose.

Coauthor(s)

Chi Hiong U Go, MD  Assistant Professor, Department of Internal Medicine, Texas Tech University Health Science Center at Odessa

Chi Hiong U Go, MD is a member of the following medical societies: American College of Physicians-American Society of Internal Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Larry I Lutwick, MD  Professor of Medicine, State University of New York Downstate Medical School; Director, Infectious Diseases, Veterans Affairs New York Harbor Health Care System, Brooklyn Campus

Larry I Lutwick, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Charles V Sanders, MD  Edgar Hull Professor and Chairman, Department of Internal Medicine, Professor of Microbiology, Immunology and Parasitology, Louisiana State University School of Medicine at New Orleans; Medical Director, Medicine Hospital Center, Charity Hospital and Medical Center of Louisiana at New Orleans; Consulting Staff, Ochsner Medical Center

Charles V Sanders, MD is a member of the following medical societies: Alliance for the Prudent Use of Antibiotics, Alpha Omega Alpha, American Association for the Advancement of Science, American Association of University Professors, American Clinical and Climatological Association, American College of Physician Executives, American College of Physicians, American Federation for Medical Research, American Foundation for AIDS Research, American Geriatrics Society, American Lung Association, American Medical Association, American Society for Microbiology, American Thoracic Society, American Venereal Disease Association, Association for Professionals in Infection Control and Epidemiology, Association of American Medical Colleges, Association of American Physicians, Association of Professors of Medicine, Infectious Disease Society for Obstetrics and Gynecology, Infectious Diseases Society of America, Louisiana State Medical Society, Orleans Parish Medical Society, Royal Society of Medicine, Sigma Xi, Society of General Internal Medicine, Southeastern Clinical Club, Southern Medical Association, Southern Society for Clinical Investigation, and Southwestern Association of Clinical Microbiology

Disclosure: Baxter International and Johnson & Johnson Royalty Other

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Eleftherios Mylonakis, MD, to the development and writing of this article.

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Escherichia coli liver abscess.
Escherichia coli right pyelonephritis.
Escherichia coli on Gram stain. Gram-negative bacilli.
Escherichia coli culture on MacConkey agar.
Table. Differential Diagnoses of E coli Infection
OrganismInd*UreaseMotilityGlu Ferm†Lact Ferm‡Sucr Ferm§Malt Ferm||Esc Hyd¶Hyd Sulf TSI#OxidaseOrn Dec**Lys Dec††
E coli+-++++/-+---+/-+
Klebsiella pneumoniae-+/--+++++---+
P mirabilis-+++----+-+-
Proteus vulgaris++++-+++/-+---
Pseudomonas aeruginosa-+/-++



(ox)‡‡



-----+--
Enterobacter aerogenes--++++++--++
Enterobacter cloacae--+++++---+-
Salmonella typhi--++--+-+--+
Citrobacter freundii+/--+++++-+/----
Serratia marcescens-+/-++-+++--++
*Indole



†Glucose fermentation



‡Lactose fermentation



§Sucrose fermentation



||Maltose fermentation



¶Esculin hydrolysis



#Hydrogen sulfite on TSI



**Ornithine decarboxylase



††Lysine decarboxylase



‡‡Oxidative



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