ABSTRACT
Escherichia coli is known to cause diarrhea in man through two well-described pathogenic mechanisms: production of enterotoxin and invasion of the intestinal mucosa. This chapter suggests that another mechanism by which E. coli can cause gastroenteritis in man. The pathogenesis of this diarrheal disease involves apparent adherence of organisms to the intestinal mucosa and damage to luminal microvilli in the absence of either conventional toxin production or invasion of the intestinal wall. Little information is available concerning the role of bacterial adherence in the pathogenesis of infantile diarrhea. A form of infantile enterocolitis has been described which has been associated with strains of E. coli previously characterized as enteropathogenic. The pathogenesis of this diarrheal illness appears to be related to adherence of organisms to the bowel luminal surface and damage to microvilli. Because human disease mechanism has only been described in man, the frequency of this illness and its overall role in infantile E. coli diarrhea remains to be determined.
