Shiga toxin-producing E. coli is associated with which serious outcome?

• A. Kidney damage (hemolytic uremic syndrome)
• B. Liver failure
• C. Skin ulcers
• D. Respiratory failure

Answer: (A)

Shiga toxin–producing E. coli most famously leads to a serious kidney complication called hemolytic uremic syndrome, which is a form of kidney damage. The Shiga toxin injures the lining of small blood vessels, especially in the kidneys, causing red blood cells to break down and platelets to drop. This creates microthrombi that clog the små vessels, leading to acute kidney injury and the other features of HUS, such as anemia and low platelets. That connection to kidney injury is why kidney damage is the correct association.

Liver failure, skin ulcers, and respiratory failure are not typical, defining outcomes of Shiga toxin–producing E. coli infections.