New guidance on management of E coli O157

Health Protection Scotland has produced new guidance on the public health management of E coli O157.

During this process, they composed an algorithm to aid practitioners in the early management of patients presenting with bloody diarrhoea and acute abdominal pain. This algorithm has been approved by SIGN and NHS 24.

Click on the thumbnail picture below to view the algorithm in full screen.


The clinical implications of missing a verotoxigenic E coli (VTEC) infection can be serious. GPs and front-line hospital staff should consider VTEC infection in the differential diagnosis of anyone presenting to them with diarrhoea.

VTEC infection may be suspected on clinical grounds (e.g. acute bloody diarrhoea, frequent motions, severe pain, and absence of fever) or epidemiological grounds (e.g. contact with farm animals or other biologically plausible exposure).

Acute bloody diarrhoea is a medical emergency especially in a child under 16 years of age.

VTEC infection should be suspected and faeces always sent for culture as quickly as possible in all cases of acute bloody diarrhoea without another explanation.

View the guidance from Health Protection Scotland

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