{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T22:15:45Z","timestamp":1767910545063,"version":"3.49.0"},"reference-count":38,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2002,8,1]]},"abstract":"<jats:p>Objective. Severe pneumococcal infections have been associated with hemolytic uremic syndrome (HUS), usually with a poor clinical outcome when compared with Escherichia coli O157 gastroenteritis-associated (D+) HUS. We examined our experience with 12 cases of Streptococcus pneumoniae-associated HUS (SP-HUS) and compare it with a cohort of diarrhea-associated HUS (D+ HUS).<\/jats:p><jats:p>Methods. A retrospective case survey compared 2 unrelated groups of HUS patients. Demographic factors, clinical indices of disease severity, and outcome were used to compare the 2 groups of HUS patients.<\/jats:p><jats:p>Results. Twelve children with SP-HUS were studied. Pneumococcal pneumonia with empyema was the most common precipitating illness (67%), pneumococcal meningitis was present in 17% of children, pneumonia with bacteremia in 8%, and both pneumonia and meningitis in 8%. SP-HUS patients were younger than D+ HUS patients (22.1 vs 49 months) and had more severe renal and hematologic disease than D+ HUS patients. Compared with D+ HUS patients, SP-HUS patients were more likely to require dialysis (75% vs 59%) and had a longer duration of hospitalization (33.2 vs 16.1 days) and duration of thrombocytopenia (11.6 vs 6.8 days). SP-HUS patients were also more likely to require platelet transfusions (83% vs 47%) and needed more platelet (4.7 vs 0.5) and packed red blood cell transfusions (7.8 vs 2.0). The 2 groups did not differ significantly in the incidence of extrarenal HUS complications. There were no deaths in either group. Seven patients have been seen for long-term follow-up; 2 developed end-stage renal disease, and 5 have normal renal function.<\/jats:p><jats:p>Conclusions. HUS is a rare but severe complication of invasive pneumococcal infection. Although disseminated intravascular coagulation can also occur in these children, the treatment and follow-up may be different in the 2 conditions. Children with pneumococcal disease and severe hematologic or renal abnormalities should be investigated for evidence of HUS.<\/jats:p>","DOI":"10.1542\/peds.110.2.371","type":"journal-article","created":{"date-parts":[[2004,8,14]],"date-time":"2004-08-14T00:17:55Z","timestamp":1092442675000},"page":"371-376","source":"Crossref","is-referenced-by-count":121,"title":["Invasive Pneumococcal Disease and Hemolytic Uremic Syndrome"],"prefix":"10.1542","volume":"110","author":[{"given":"John","family":"Brandt","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Hospital of New Mexico, Albuquerque, New Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Craig","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Hospital of New Mexico, Albuquerque, New Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Mihm","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Texas Children\u2019s Hospital, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Hospital and Medical Center, Seattle, Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jodi","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Hospital and Medical Center, Seattle, Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eileen","family":"Brewer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Texas Children\u2019s Hospital, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ravi","family":"Thiagarajan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Hospital and Medical Center, Seattle, Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley","family":"Warady","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Mercy Hospital, Kansas City, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2002,8,1]]},"reference":[{"key":"2021121006311654300_R1","unstructured":"Moghal NE, Brocklebank JT, Meadow SR. 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