What are the signs and symptoms of Escherichia coli (E coli) intra-abdominal infections?

Updated: Feb 11, 2019
  • Author: Tarun Madappa, MD, MPH; Chief Editor: Michael Stuart Bronze, MD  more...
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Patients with E coli cholecystitis or cholangitis develop right upper quadrant (RUQ) pain, fever, and jaundice. In severe cases, hypotension and confusion also develop. Cholecystitis manifests with fever (>102°F). Cholangitis manifests with fever (>102°F), shaking chills, and RUQ pain and can be complicated by hepatic abscess. Amebic liver abscess, Echinococcus cyst, and Klebsiella and Enterococcus infections are difficult to distinguish clinically. Anaerobes are observed in patients with diabetes and acute acalculous cholecystitis.

Patients with E coli intra-abdominal abscesses may have low-grade fever, but the spectrum of clinical presentations ranges from nonspecific abdominal examination findings to frank septic shock. Peritonitis manifests as localized pain with rebound and fever. The presentation ranges from low-grade fever with abdominal tenderness, weakness, malaise, and anorexia to hypoxemia and hypotension. The infection is usually polymicrobial with E coli and other gram-negative bacilli and anaerobes. The differential diagnoses include retroperitoneal hematoma and septic thrombophlebitis.

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