Isaac's head becomes covered in feces after gaining this item.
This works with the Midas Touch to turn enemies into golden poop, making the combination very profitable.
Escherichia coli is an actual bacterium found in the lower intestine of warm-blooded organisms. Most strains of this bacterium are harmless, but there are pathogenic ones that this item refers to. Unlike the actual rod-shaped E. Coli, the item's body is rounder, and possesses a flagellum (tail).