Urinary Escherichia coli infection presenting with jaundice.

A 53-year-old man with lupus erythematosus (LE) developed an acute hemolytic crisis. Alpha-hemolytic Escherichia coli were isolated from the patient's urine and feces, and high titer anti-alpha-hemolytic antibodies appeared in his serum. The hemolytic crisis could be controlled by specific antibiotic treatment of the urinary tract infection. It is assumed that the patient's basic disease -- and the steroid therapy applied -- facilitated the progression of the urinary tract infection, and before starting with adequate antibiotic treatment his erythrocytes must have been subjected to the effect of massive amounts of alpha-hemolysin. The idea that alpha-hemolysin might contribute to the development of severe hemolysis in man is discussed. It is also assumed that harbouring alpha-hemolytic E. coli in the gut may represent a special risk for the immunocompromised host.