Growth occurs on Mac Conkey agar with Sorbitol as clear colonies. This special media is required since all E. coli look similar and produce typical pink colonies on Mac Conkey agar. EHEC do not ferment sorbitol. Clinical Correlation EHEC is non-invasive and infects large bowel mucosa resulting in bloody, watery diarrhea with no fever or pus in the stool. Diarrhea and crampy abdominal pain are common.
Organisms are commensal in cattle.
Thus the association with beef products and unpasteurized cider from apples found in cow pastures. Many strains produce Shiga-toxin resulting in hemolytic uremic syndrome. Prolonged use of anti motility agents is associated with more systemic complications of EHEC infection. Treatment is re-hydration. The role of antibiotics is uncertain.