Verotoxin (vtx) or shiga-like toxin (stx) can be found in several E. coli serotypes including 0157:H7 and also Shigella dysenteriae. It was described in Germany an outbreak of this novel Escherichia coli O104:H4 which caused bloody diarrhea and hemolytic-uremic syndrome (HUS). Streptococcus pneumoniae, Campylobacter and viruses also can cause HUS.