{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:02:06Z","timestamp":1792789326714,"version":"4.5.0"},"reference-count":22,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T00:00:00Z","timestamp":1712793600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy Carol Davila"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Shiga-like toxin-producing Escherichia coli (STEC) is a well-known cause of foodborne acute diarrheic diseases, especially in children and the elderly. The potentially fatal complications associated with toxin production range from bloody diarrhea and ischemic colitis to kidney failure, hemolytic\u2013uremic syndrome (HUS), and colon perforation. Here, we describe a case and literature review of STEC-induced colitis, highlighting the clinical features and the necessary tools for the best diagnostic approach and management. Facing challenging differential diagnosis, ranging from ischemic colitis and inflammatory bowel disease to infectious processes due to a pathogenic or opportunistic agent, we conducted a step-by-step exploration. Following bacteriological investigation, imagistic screening, and colonoscopy, we ruled out some of the initial suppositions and reached a final diagnosis, while also considering the pathological results. Although antibiotics are not indicated in this pathology, our patient did receive antibiotics, given the risk of translocation and colon perforation, without any associated complications such as HUS or peritonitis. Detailed and rigorous investigations conducted by a multi-specialty team are required for prompt medical support. Coping with the symptoms and refraining from further complications are the mainstem aims of treatment.<\/jats:p>","DOI":"10.3390\/diagnostics14080801","type":"journal-article","created":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T07:09:28Z","timestamp":1712819368000},"page":"801","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Successful Approach to Diagnosing Shiga-like Toxin-Producing Escherichia coli-Induced Colitis"],"prefix":"10.3390","volume":"14","author":[{"given":"Violeta","family":"Melinte","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0442-505X","authenticated-orcid":false,"given":"Adelina M.","family":"Radu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina M.","family":"V\u0103c\u0103roiu","sequence":"additional","affiliation":[{"name":"Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriana I.","family":"Cismaru","sequence":"additional","affiliation":[{"name":"Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anca M.","family":"Oprescu Macovei","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela E.","family":"Mih\u0103il\u0103","sequence":"additional","affiliation":[{"name":"Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7819-5464","authenticated-orcid":false,"given":"Valeriu","family":"Gheorghi\u021b\u0103","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"EHEC-0001-2013","DOI":"10.1128\/microbiolspec.EHEC-0001-2013","article-title":"Detection of Shiga Toxin-Producing Escherichia coli from Nonhuman Sources and Strain Typing","volume":"2","author":"Beutin","year":"2014","journal-title":"Microbiol. 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Spectr."},{"key":"ref_5","first-page":"25","article-title":"Detection of plasma anti-lipopolysaccharide (LPS) antibodies against enterohemorrhagic Escherichia coli (EHEC) in asymptomatic kindergarten teachers from Buenos Aires province","volume":"56","author":"Sacerdoti","year":"2023","journal-title":"Rev. Argent. Microbiol."},{"key":"ref_6","unstructured":"Azer, S.A., and Tuma, F. (2023, December 28). Infectious Colitis, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK544325\/."},{"key":"ref_7","first-page":"e37092","article-title":"Breaking Down the Gut: A Case of Severe Toxin-Mediated Colitis","volume":"15","author":"Shahwan","year":"2023","journal-title":"Cureus"},{"key":"ref_8","unstructured":"European Centre for Disease Prevention and Control (2022). 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Microbiol., 10.","DOI":"10.3389\/fcimb.2020.00169"},{"key":"ref_12","first-page":"336","article-title":"The outcomes and prognostic factors of surgical treatment for ischemic colitis: What can we do for a better outcome?","volume":"61","author":"Ryoo","year":"2014","journal-title":"Hepatogastroenterology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e00629","DOI":"10.1016\/j.idcr.2019.e00629","article-title":"Infection due to Shiga toxin-producing enterohemorrhagic Escherichia coli (EHEC) presenting as ischemic colitis","volume":"18","author":"Tanquilut","year":"2019","journal-title":"IDCases"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"S841","DOI":"10.14309\/01.ajg.0000781192.49396.ab","article-title":"S1915 A Sporadic Case of Shiga Toxin-Producing Enterohemorrhagic Escherichia Coli O111 Infection Manifesting as Ischemic Colitis","volume":"116","author":"Caldis","year":"2021","journal-title":"Am. J. 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Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1159\/000360846","article-title":"Successful Colectomy for Hemorrhagic Colitis with Hemolytic Uremic Syndrome and Acute Encephalopathy due to Escherichia coli O157 Infection","volume":"8","author":"Tominaga","year":"2014","journal-title":"Case Rep. Gastroenterol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Radhakrishnan, S.T., Ruban, A., Uthayakumar, A.K., Cohen, P., Levy, J., and Teare, J. (2019). Haemolytic uraemic syndrome\u2014A rare case report of bloody diarrhoea in adults. BMC Gastroenterol., 19.","DOI":"10.1186\/s12876-019-1071-4"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1722","DOI":"10.1016\/S0140-6736(22)01202-8","article-title":"Haemolytic uraemic syndrome","volume":"400","author":"Michael","year":"2022","journal-title":"Lancet"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/s13099-019-0327-4","article-title":"Shiga toxin producing Escherichia coli-associated diarrhea and hemolytic uremic syndrome in young children in Romania","volume":"11","author":"Lixandru","year":"2019","journal-title":"Gut Pathog."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"30170","DOI":"10.2807\/1560-7917.ES.2016.21.11.30170","article-title":"Early findings in outbreak of haemolytic uraemic syndrome among young children caused by Shiga toxin-producing Escherichia coli, Romania, January to February 2016","volume":"21","author":"Peron","year":"2016","journal-title":"Eurosurveillance"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/8\/801\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:26:10Z","timestamp":1760106370000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/8\/801"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,11]]},"references-count":22,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["diagnostics14080801"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics14080801","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,11]]}}}