To the Editor: I am prompted to comment on the “environmental factor” that was suggested as a possible cause of the hemolyticuremic syndrome by Kaplan, Chesney and Drummond in their recent article (N Engl J Med 292:1090, 1975). Recently, we reported the association of shigella infection and the hemolyticuremic syndrome (Rahaman MM, Jamiul Alam AKM, Islam MR, et al: Shiga bacillus dysentery associated with marked leukocytosis and erythrocyte fragmentation. Johns Hopkins Med J 136:65–70, 1975). In addition, there was an associated leukemoid reaction. When the infections were due to Shigella dysenteriae, the incidence of this reaction was considerable (9.2…, No extract is available for articles shorter than 400 words.
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