Escherichia coli serotype O157:H7 causes serious food poisoning worldwide, especially in children and elderly people.1 It is also called verotoxin producingE coli (VTEC), which produces a cytotoxic Shiga-like toxin. Gastrointestinal, haemorrhagic, and uraemic effects are well known in VTEC infection,2 and neurological problems are likely to be more frequent than is generally recognised.3 Here we describe axonal polyneuropathy and encephalopathy in a young female patient associated with haemolytic-uraemic syndrome caused by VTEC infection.

A 26 year old woman began to have abdominal pain and haemorrhagic diarrhoea. She was admitted to an emergency hospital and diagnosed as having haemorrhagic colitis due to probable food poisoning. Then her urinary volume gradually decreased and serum creatinine increased, and she was transferred to our hospital. On the 9th day she had a high fever of 39.7°C with increased C reactive protein of 7.6 mg/l and a leukocytosis of 17 800/mm³. She was in a state of anuria and her blood analysis showed severe kidney dysfunction (increased serum creatinine of 6.76 mg/l). She had severe anaemia (haemoglobin 6.0 g/dl), fragmentation, and tear drop deformation of red blood cells in the blood smear and increased lactate dehydrogenase …