Hemolytic uremic syndrome complicated by Clostridium septicum bacteremia and new-onset type 1 diabetes mellitus. Report of a case

We report the unusual case of a 5-year-old male hospitalized for management of diabetic ketoacidosis (DKA) and new-onset type 1 diabetes mellitus (T1DM) who developed acute renal injury secondary to hemolytic uremic syndrome (HUS). He was diagnosed with Shiga toxin-producing entero-hemorrhagic Escherichia coli (EHEC) 0157:H7-positive HUS 48 hours after being diagnosed with new-onset T1DM/ DKA. His hospital course was complicated by Clostridium septicum sepsis with colonic perforation. This patient's diagnosis of new-onset T1DM just prior to HUS is novel. Furthermore, some cases of HUS and concurrent atraumatic C. septicum infection have been documented, but only two other survivor cases have been found, and no previous cases report of concurrent T1DM complicating atraumatic C. Septicum infection have been documented so far. Aggressive surgical management and appropriate early antibiotic therapy may have been important for this child's survival.