Abstract
This case report describes a previously healthy 43-year-old woman who developed haemolytic uraemic syndrome (HUS) following Escherichia coli sepsis. She presented with vomiting, diarrhoea, fever, right upper quadrant pain, and altered mental status after returning from travel to Bali and Australia. Initial investigations revealed stage 3 acute kidney injury, deranged liver function, anaemia, thrombocytopenia, and raised inflammatory markers. Blood and urine cultures confirmed E. coli, and she was treated with intravenous antibiotics and supportive care. A peripheral blood film showed features of microangiopathic haemolysis, consistent with HUS, although Shiga toxin testing was not reported in this case. Her condition gradually improved with conservative management. This case highlights the need to consider HUS in adults with E. coli sepsis, even without confirmed Shiga toxin, and the importance of prompt supportive treatment.