Symptoms and signs of gastroenteritis
STEC-HUS happens in a few children after they have gastroenteritis, an infection in the tummy (or gut) that is caused by shiga-toxin-producing E. coli (STEC).
Symptoms and signs include:
- diarrhoea for several days
- feeling sick (nausea), being sick (vomiting) or tummy pain
- fever (temperature above 38°C) – some children may sweat and/or seem shivery
- sometimes, blood in the stool (poo), which may start a few days after children first get diarrhoea.
If your child has blood in his or her stool, take him or her to your family doctor.Infections can spread very easily. Your doctor may ask you to take your child out of school or nursery to avoid passing it on to other children.
Symptoms and signs of STEC-HUS
Most children recover from gastroenteritis. In a few children, the infection triggers STEC-HUS. Some children have the following symptoms:
- urinating (weeing) less often, passing smaller amounts of urine, or, sometimes, not urinating at all
- feeling weak and tired, and sometimes looking paler than usual – caused by a drop in the amount of red blood cells or haemoglobin, a substance in red blood cells, which normally carry oxygen round the body (anaemia)
- occasionally, tiny pink or purple spots on their skin – caused by a drop in the amount of platelets, blood cells that help the body to heal (thrombocytopenia).
Complications
Some children have complications, more serious health problems.
Your child’s healthcare team will carefully check for complications. They will talk about the treatment options with you.
Kidneys
The kidneys do not work as well as normal in this disease – we say there is reduced kidney function.
Many children will go into acute kidney injury (AKI) – when the kidneys suddenly fail or stop working properly. This is measured with a blood test – when there is too much of a waste product called creatinine, which is normally removed by the kidneys in urine. HUS is the most common cause of AKI in children. Some children with AKI need to take medicines or have more intensive treatment such as dialysis, which uses special equipment to remove wastes and extra water and salts from the body. Children with AKI may have the following:
- blood pressure that is too high (hypertension) – this may cause headaches, vomiting or blurred (fuzzy) vision; blood pressure can be controlled by changes to the diet or, sometimes, medicines
- swelling or puffiness in their body (oedema), especially around their eyes or legs and feet – this happens when their kidneys cannot remove enough salt and water from their body in urine
- feeling breathless – this happens when fluid builds up in the area around their lungs.
Blood sugar
A small number of children with HUS get high levels of sugar in their blood. This happens when the pancreas, which makes and releases chemicals that break down food, becomes inflamed – this is called pancreatitis. This may cause burning pain in the tummy and back, nausea and vomiting.
The pancreas makes the hormone insulin, which controls the level of sugar in the blood. If it is inflamed, it cannot make enough insulin, and this may lead to acute diabetes, when the body has too much sugar. Children will need to be given insulin by injection. It is usually temporary, but children need follow-up.
Bowel
The E. coli infection that causes STEC-HUS affects the colon (large intestine, or part of the bowel). Some children get colitis – when the colon becomes inflamed and irritated. Children may get tummy pain or cramps, may have stomach pain and may feel tired. Some children cannot eat normally – they may need to get nutrition into their blood using a plastic tube in a vein. Occasionally, surgery is needed.
Central nervous system, including brain
Rarely, HUS affects the central nervous system, including the spine and brain – this is called cerebral HUS. This can lead to:
- seizures – also called convulsions or fits
- problems with vision
- very occasionally, paralysis – when part of the body is unable to move.