Specialized pediatric care for serious complications of the E. coli infection is becoming increasingly common.
By Debra Bresnan
As seen in the May/June 2019 issue of Advancing Care
For most, a bout with E. coli means severe pain and extreme gastrointestinal (GI) distress. But for children diagnosed with one particular strain of this increasingly common GI infection, the stakes can be far higher: permanent kidney damage.
Thanks to the interdisciplinary pediatric care team at Maria Fareri Children’s Hospital, a member of the Westchester Medical Center Health Network (WMCHealth), two young girls have recovered from severe E. coli-related complications to resume healthy, normal lives.
Quinn: A Return to the Active Life
On the Monday after Thanksgiving 2017, 9-year-old Quinn McGuire of Ridgefield, CT, began experiencing a stomach ache. The next day, with her belly pain increasing, she visited the pediatrician. But later that night, when Quinn developed bloody diarrhea, “I knew something was terribly wrong,” recalls Quinn’s mom, Kateri, a pediatric nurse practitioner. “We took her right away to Maria Fareri Children’s Hospital.”
Pediatric nephrologist Tanya Pereira, MD, and Dmitry Samsonov, MD, Chief of Pediatric Nephrology at Maria Fareri Children’s Hospital, diagnosed Quinn with E. coli, which progressed to Hemolytic Uremic Syndrome (HUS), a condition that destroys red blood cells and damages the kidneys’ tiny blood vessels. Quinn remained in the Pediatric Intensive Care Unit (PICU) for nearly three weeks, where she was placed on dialysis and received blood and platelet transfusions.
“The care we received in the PICU was phenomenal — from the doctors to the nurses and the Child Life specialist,” says Kateri. “With my medical background, I know that where you go first matters. We thought she had food poisoning, but this was life-threatening. There was a seamless transition from the Emergency Room to the inpatient unit to intensive care to care by specialists. The pediatric, renal, infectious disease and other disciplines all worked collaboratively.”
Today, Quinn’s kidney function is normal, and she follows up with her renal doctors every six months. “She’s very energetic and has diverse interests,” says Kateri. “She enjoys soccer, basketball, lacrosse and Girl Scouts. We’re extremely thankful for the care we got and want other people to know how important it is to be treated at a place where the care you need is at your fingertips.”
Amanda: Inspired to Give Back
Yorktown resident Amanda Carlson, 14, also contracted the E. coli Shiga toxin and experienced HUS as a complication.
“Amanda was admitted with diarrhea and was on intravenous fluids, to get hydrated,” says Dr. Pereira. “We were about to discharge her when we noticed an abnormality in her blood work indicating HUS.” Though Amanda didn’t need dialysis, she did require transfusions and remained hospitalized at Maria Fareri Children’s Hospital for nearly three weeks over Thanksgiving in 2016.
“All of the nurses kept me so happy. There were games, movies, arts and crafts,” she remembers. “The last thing I needed was to be worrying, and I wasn’t.”
Inspired by the care she received, Amanda launched fundraisers for the hospital when she recovered. The first, in January 2017, raised $8,000 for a Fun Center machine, loaded with a computer, Virtual Reality, Xbox and other popular entertainment technologies. Subsequent fund drives raised $9,000 for toys and gift cards.
Today, Amanda sees her nephrologist every three months to monitor her borderline high blood pressure, a consequence of HUS. “Otherwise, I’m 100 percent healthy. I like volleyball – I play at school, in town and at a private all-star club. I also like to draw, paint, sew… anything artistic.”
“Amanda wrote a school essay about how fortunate we are to have a specialized pediatric trauma center for kids from birth to age 21,” says her mom, Maria. “The first few days, she was in so much pain. It was horrifying for us. Then, when HUS set in, it was another kind of scary. Now she’s thriving, doing well in high school and playing sports. Our family will always remember what Maria Fareri Children’s Hospital did for us.”
E.Coli: A Growing Pediatric Health Risk
“We’re seeing more cases of E. coli infection than in recent years,” says Dmitry Samsonov, MD, Chief of Pediatric Nephrology at Maria Fareri Children’s Hospital, citing recent outbreaks prompting the removal of romaine lettuce from grocery shelves nationwide.
Although mild cases of E. coli bacterial infection may be monitored and treated under the care of your family’s pediatrician or health practitioner, severe cases require treatment by a pediatric kidney specialist.
“E. coli Shiga toxin bacteria in the system causes diarrhea and inflammation inside blood vessels, which can result in renal failure,” says Dr. Samsonov. This condition can progress to Hemolytic Uremic Syndrome (HUS).
As the HUS infection progresses, your child may not urinate as usual and may look pale and swollen. “Antibiotics do not prevent the disease progression, and there is no specific treatment for this disease,” says Dr. Samsonov. “At the first sign of bloody diarrhea, take your child to a pediatrician right away to perform a stool culture.”
“HUS is caused by bacteria — most commonly E. coli — entering the GI tract, mostly through contact with tainted food or infected feces,” says Tanya Pereira, MD, pediatric nephrologist at Maria Fareri Children’s Hospital. “To minimize your risk of infection,” she says, “use common-sense precautions, such as properly cooking food, washing vegetables and fruits, avoiding unpasteurized milk and cider, and washing your hands thoroughly and often.”
Visit us at Maria Fareri Children’s Hospital, a member of Westchester Medical Center Health Network, to learn more. Advancing Care. Here.
Photos by Rachel Crittenden