Sepsis and Intestinal E. coli Infections

Escherichia coli (E. coli) are bacteria that are all around you. You can find E. coli everywhere in your environment, including on your skin and in your intestines. Most strains of E. coli are harmless but some strains can make you very sick and can cause sepsis.

Sepsis, which was often called blood poisoning, is the body’s life-threatening response to infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment.

Suggested Citation:
Sepsis Alliance. Sepsis and Intestinal E. coli infections. 2024.

Updated January 19, 2024.


More About E. coli


An E. coli infection spreads from person to person and from animal to person. You can also contract the infection by touching a contaminated object or consuming contaminated food or drink.

The type of E. coli infection we may be most familiar with is often referred to as travelers’ diarrhea. This type of infection is caused by the enterotoxigenic E. coli (ETEC) bacteria. These bacteria produce substances that are toxic (poisonous) to intestinal cells. The toxins stimulate the intestinal wall lining, which then produces more fluid and this causes diarrhea.

Travelers may get the infection by drinking unclean water or eating food that hasn’t been properly prepared. Closer to home, there are often reports in the news of E. coli outbreaks or recalls for processed foods that may be contaminated with the bacteria.

Food and water:

  • Contaminated ground beef is one of the most common causes of E. coli infection. Thorough cooking will kill the bacteria.
  •  E. coli bacteria found on a cow’s udder or milking equipment can get into raw milk. Pasteurizing the milk will kill the bacteria.
  • Fresh produce can be contaminated with E. coli as it comes in touch with the runoff from cattle farms. The bacteria can also transfer to fresh produce during harvesting and packing if the workers or the equipment carry the bacteria.
  • Human and animal feces may pollute ground and surface water.

Personal contact

  • People can spread E. coli bacteria. It can easily travel from person to person if someone has the bacteria on their hands, most often when infected adults and children don’t wash their hands properly. Children who visit petting zoos and animal barns can also contract the infection after touching the animals.

The symptoms of an E. coli infection can be much more serious among infants and seniors, as well as people who are already ill. It can take anywhere from one to seven days for the symptoms to appear after exposure to the bacteria. The most commonly known symptoms are severe abdominal cramping and watery or bloody diarrhea. Others include:

  • Nausea
  • Vomiting
  • Headache
  • Mild fever

Most healthy people recover from an E. coli infection in a week or so. However, young children and seniors, as well as anyone who is medically fragile can become very ill quite quickly. The diarrhea and vomiting can cause dehydration. If you are experiencing severe diarrhea and/or vomiting, consult with your doctor or nurse practitioner as soon as possible.

E. coli infection can also lead to a life-threatening complication of the kidneys called hemolytic uremic syndrome. If you experience any of these symptoms, see your doctor or go to an emergency department immediately:

  • Decreased urine output
  • Unexplained bruises
  • Unusual bleeding
  • Extreme fatigue

E. coli infection can lead to sepsis, so it is important to watch for the signs and symptoms of sepsis, particularly among seniors.


There is no treatment for E. coli infection yet. Treatment focuses on staying hydrated and resting. If necessary, your doctor may recommend IV fluids for hydration. It may be tempting to take an anti-diarrhea medication, but if you have an infection, this could slow down your body’s efforts to naturally expel the toxin, so check with your doctor first. There are no antibiotics for most E. coli infections.

If you have contracted traveler’s diarrhea, your doctor may recommend that you do take anti-diarrhea medications for a short period or bismuth subsalicylate (Pepto-Bismol). In some instances, doctors treat the infection with antibiotics.


We can’t prevent all infections, but the chances of developing an E. coli infection are lower if you follow these tips:

  • Cook all meat thoroughly, particularly ground beef or mechanically tenderized meat.
  • Don’t reuse cutting boards or utensils after using them for meat products unless they’ve been washed in hot, soapy water first.
  • Drink only pasteurized milk and eat pasteurized dairy products.
  • Wash all fruits and vegetables thoroughly.
  • Wash your hands thoroughly, especially after touching animals and before and after handling food.

To reduce the risk of contracting travelers’ diarrhea while in countries where the bacteria is more common:

  • Drink bottled water and use bottled water to brush your teeth
  • Do not eat undercooked foods.
  • Do not use ice cubes made with tap water
  • Eat fruits that you can peel yourself
  • Wash your hands frequently

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Joseph Felo

I will tell you about my son, who had a bone marrow transplant on 12/2018 and had many complications along the way. (Sepsis and Impaired Immune System) In September 2019 my son turned 29, and a week after this he began having pain on upper right side of his chest, was instructed to go to the nearest ER. We went to ER and he was transported by ambulance to Roswell in Buffalo. He was inpatient for 5 days and we went to Buffalo to bring him home, and I asked him why his stomach was so bloated and he said ... Read Full Story

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