Shiga Toxin-Producing Escherichia coli-Associated Hemolytic Uremic Syndrome Following Neoadjuvant Chemotherapy for Advanced Ovarian Cancer: A Case Report.

Hemolytic uremic syndrome (HUS) is an uncommon but serious cause of thrombotic microangiopathy (TMA) in adults and can pose diagnostic challenges, especially in patients receiving chemotherapy, due to overlapping features with chemotherapy-induced TMA. We report the case of a 55-year-old woman with advanced ovarian cancer undergoing neoadjuvant chemotherapy who developed Shiga toxin-producing Escherichia coli (STEC)-associated HUS. The patient developed severe oligo-anuric acute kidney injury (AKI), requiring hemodialysis and multiple transfusions. Early recognition, prompt supportive care, and multidisciplinary management were critical for stabilization and safe continuation of oncologic therapy. This case highlights the importance of considering STEC-HUS in immunocompromised adults presenting with TMA during oncologic chemotherapy.