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Enteroinvasive escherichiosis in children: causes, symptoms, diagnosis, treatment

Alexey Kryvenko, medical expert
Last reviewed: 07.07.2025

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Enteroinvasive escherichiosis is observed mainly in children over 3 years of age and in adults. The leading serovars are 0124 and 0151, less common are 025, 028, 032, 0112, 0115, 0129, 0135, 0136, 0143, 0144, 0152.

Escherichia coli of this group are able to penetrate into the epithelial cells of the colon and multiply in them (intracellularly). Many serovars have antigenic affinity with Shigella by O-antigen and with Klebsiella pneumoniae by K-antigen.

ICD-10 code

A04.2 Enteroinvasive Escherichia coli infection.

Epidemiology

Infection usually occurs through food, but waterborne infection is also possible. The disease occurs in the form of both sporadic cases and group epidemic outbreaks (as with shigellosis), mainly in the summer-autumn period.

Pathogenesis of enteroinvasive escherichiosis

Enteroinvasive Escherichia coli live and reproduce primarily in the large intestine and cause “dysentery-like” diseases with similar pathogenesis and interaction with the intestinal epithelium.

Symptoms of enteroinvasive escherichiosis

The incubation period of enteroinvasive escherichiosis is usually 1-3 days. The disease usually begins acutely, with a rise in body temperature, headache, nausea, often vomiting, moderate abdominal pain. At the same time or after a few hours, loose stools with pathological impurities appear. Symptoms of intoxication are detectable only in the first 1-2 days of the disease (maximum 3 days). The general condition of the patient is slightly impaired, hyperthermic syndrome (as with shigellosis) does not occur. Moderate fever no more than 1-3 days.

Palpation of the abdomen reveals rumbling and pain, first throughout the abdomen and then mainly along the colon. The sigmoid colon is palpated as a spasmodic, moderately infiltrated and painful cord. The anus is closed, tenesmus. as a rule, does not occur. The stool is most often fecal, up to 3-5 times a day, less often up to 7-10 times. with an admixture of cloudy mucus, sometimes - greenery and streaks of blood. Unlike shigellosis, there is usually no admixture of pus, the feces are not scanty. The disease ends quickly: the body temperature drops to normal in 2-3 days, clinical manifestations of intoxication disappear, on the 3rd-5th day the stool is normalized.

In terms of the nature of the course, enteroinvasive escherichiosis is practically indistinguishable from mild and moderate forms of shigellosis. The etiological diagnosis can only be established based on the results of laboratory research methods.

Treatment and prevention of enteroinvasive escherichiosis

The same as shigellosis.

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