{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T10:04:51Z","timestamp":1775815491995,"version":"3.50.1"},"reference-count":12,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2026,4]]},"abstract":"ABSTRACT<\/jats:title>\n \n Animal exhibits can be a source of\n \n E. coli<\/jats:styled-content>\n O157:h7\n <\/jats:italic>\n transmission and may lead to hemolytic uremic syndrome. The\n \n E. coli<\/jats:styled-content>\n O157:h7\n <\/jats:italic>\n outbreak in Tennessee affected over 64 children. Five children, 15\u2009months to 7\u2009years of age, developed acute renal failure due to HUS, requiring renal replacement therapy. They were admitted to the hospital with acute renal failure between 7 and 12\u2009days after exposure to animals. All children presented with vomiting, diarrhea, abdominal pain, and oligo\u2010anuria and had laboratory confirmation of\n \n E. coli<\/jats:styled-content>\n O157:h7\n <\/jats:italic>\n in the stool sample. They all required renal replacement therapy, and one child required therapeutic plasma exchange due to thrombotic microangiopathy vasculitis\u2010associated encephalopathy. These children experienced dialysis catheter malfunction (\n n<\/jats:italic>\n \u2009=\u20091), encephalopathy (\n n<\/jats:italic>\n \u2009=\u20091), and thrombosis of the right jugular vein (\n n<\/jats:italic>\n \u2009=\u20091). All children developed hypertension, and three out of five required anti\u2010hypertensives at discharge. At the 1\u2010year follow\u2010up, the GFR ranged from 54 to 92\u2009mL\/min. Hypertension was noted in two. Hemolytic uremic syndrome can cause long\u2010term sequelae like cerebral atrophy, hypertension, and chronic kidney disease. Hygiene measures can potentially prevent hemolytic uremic syndrome.\n <\/jats:p>","DOI":"10.1111\/hdi.70043","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T07:11:04Z","timestamp":1767856264000},"page":"425-430","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Petting Zoo Perils:\n Escherichia coli O157:h7<\/i>\n Associated Hemolytic Uremic Syndrome Secondary to Animal Exposure"],"prefix":"10.1111","volume":"30","author":[{"given":"Bailey","family":"Mims","sequence":"first","affiliation":[{"name":"Lincoln Memorial University DeBusk College of Osteopathic Medicine Knoxville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Stickles","sequence":"additional","affiliation":[{"name":"Lincoln Memorial University DeBusk College of Osteopathic Medicine Knoxville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihail M.","family":"Subtirelu","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology and Hypertension East Tennessee Children's Hospital Knoxville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7106-1527","authenticated-orcid":false,"given":"Sai Sudha","family":"Mannemuddhu","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology and Hypertension East Tennessee Children's Hospital Knoxville Tennessee USA"},{"name":"Department of Pediatrics University of Tennessee at Knoxville Knoxville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,7]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Agricultural Fairs in America: A History","author":"Womack 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