Determining site of care for children with known or suspected high-risk STEC infection

HUS: hemolytic uremic syndrome; STEC: Shiga toxin producing E. coli.

* HUS is characterized by the triad of nonimmune-mediated hemolytic anemia (hematocrit <30%), thrombocytopenia (platelet count <150,000/microL), and acute kidney injury (serum creatinine above the upper limit of normal for age).

¶ Once circulating volume has been restored, options for preserving intravascular volume include conservative fluid management (administering fluids with the goal of achieving euvolemia) or hyperhydration (anticipatory volume expansion); refer to text for further discussion.

Δ In the context of outpatient laboratory monitoring, if trends in the laboratory tests are concerning (falling platelet count, falling hematocrit, or rising creatinine), and/or the patient deteriorates clinically, switch to inpatient care.