Colonic necrosis and perforation secondary to Escherichia coli O157:H7 gastroenteritis in an adult patient without hemolytic uremic syndrome.

During a multistate outbreak of Escherichia coli O157:H7 diarrhea, we encountered a woman who had hemorrhagic colitis complicated by ischemic colitis with perforation. To our knowledge, this has not previously been described in adult patients. Because of the insensitivity of the commonly used diagnostic methods, this condition may be underrecognized.