Which complication is most associated with EHEC infection?

Hemolytic uremic syndrome (HUS) is the most severe and concerning complication associated with an infection caused by enterhemorrhagic Escherichia coli (EHEC), particularly the O157:H7 strain. EHEC infection can lead to gastrointestinal symptoms like severe abdominal cramps, bloody diarrhea, and sometimes fever.

The hallmark of HUS consists of a triad of symptoms: acute renal failure, hemolytic anemia, and thrombocytopenia (low platelet count). The mechanism by which EHEC leads to HUS involves the production of Shiga toxin, which can damage the endothelial cells in the vasculature, particularly within the kidneys. This damage triggers a cascade of events including the activation of the clotting cascade, which can lead to microangiopathic hemolytic anemia and renal impairment.

While dehydration can occur as a result of severe diarrhea, and chronic diarrhea can be a consequence of other gastrointestinal disorders, these are not specific to EHEC or as severe as HUS. Septicemia is also not commonly associated with EHEC infections since these typically do not invade the bloodstream or lead to sepsis. Hence, HUS is widely recognized as the most serious complication in EHEC infections