1887

Abstract

Background. The non-O1/non-O139 serogroups of Vibrio cholerae occur in diverse natural niches, and usually cause mild and self-limiting gastrointestinal illness. However, they have well-documented potential to cause invasive and extra-intestinal infections among immunocompromised patients. Furthermore, their ability to grow in low-salinity surface water, and the existence of asymptomatic human carriers, suggest novel acquisition routes for this unusual infection, even in people without obvious risk factors.

Case presentation. A 62-year-old man presented with epigastric pain, vomiting and fever. The patient had a history of diabetes and cholecystectomy, although our initial examination did not reveal any significant findings that might indicate V. cholerae infection. However, blood cultures subsequently revealed the presence of V. cholerae, which was positively identified using both conventional and modern non-conventional technologies. The identity of the V. cholerae isolate was confirmed using Vitek MS (matrix–assisted laser desorption ionization-time of flight MS) and the FilmArray system, in addition to its initial identification using the Vitek 2 system. The septicaemia was successfully treated using a 14 day course of ciprofloxacin.

Conclusion. The present case highlights the need to remain highly suspicious of non-O1/non-O139 V. cholerae infections in patients with known risk factors, as well as in healthy individuals with epidemiological exposure and compatible clinical symptoms. Special care should be taken to avoid false-positive results from confirmatory laboratory tests, as the organism can grow in fresh water, and the results should be verified using multiple methods.

Loading

Article metrics loading...

/content/journal/jmmcr/10.1099/jmmcr.0.005077
2017-02-28
2019-10-23
Loading full text...

Full text loading...

/deliver/fulltext/jmmcr/4/2/jmmcr005077.html?itemId=/content/journal/jmmcr/10.1099/jmmcr.0.005077&mimeType=html&fmt=ahah

References

  1. Swerdlow DL, Malenga G, Begkoyian G, Nyangulu D, Toole M et al. Epidemic cholera among refugees in Malawi, Africa: treatment and transmission. Epidemiol Infect 1997;118:207–214[PubMed][CrossRef]
    [Google Scholar]
  2. Bompangue D, Giraudoux P, Handschumacher P, Piarroux M, Sudre B et al. Lakes as source of cholera outbreaks, Democratic Republic of Congo. Emerg Infect Dis 2008;14:798–800 [CrossRef][PubMed]
    [Google Scholar]
  3. Ries AA, Vugia DJ, Beingolea L, Palacios AM, Vasquez E et al. Cholera in Piura, Peru: a modern urban epidemic. J Infect Dis 1992;166:1429–1433[PubMed][CrossRef]
    [Google Scholar]
  4. Ali M, Lopez AL, You YA, Kim YE, Sah B et al. The global burden of cholera. B World Health Organ 2012;90:209–218 [CrossRef][PubMed]
    [Google Scholar]
  5. Faruque SM, Sack DA, Sack RB, Colwell RR, Takeda Y et al. Emergence and evolution of Vibrio cholerae O139. Proc Natl Acad Sci USA 2003;100:1304–1309 [CrossRef][PubMed]
    [Google Scholar]
  6. Alam M, Hasan NA, Sadique A, Bhuiyan NA, Ahmed KU et al. Seasonal cholera caused by Vibrio cholerae serogroups O1 and O139 in the coastal aquatic environment of Bangladesh. Appl Environ Microbiol 2006;72:4096–4104 [CrossRef][PubMed]
    [Google Scholar]
  7. Mannion PT, Mellor S. Non-cholera Vibrio bacteremia associated with acute cholecystitis. BMJ 1986;292:450[CrossRef]
    [Google Scholar]
  8. Petsaris O, Nousbaum JB, Quilici ML, Le Coadou G, Payan C et al. Non-O1, non-O139 Vibrio cholerae bacteraemia in a cirrhotic patient. J Med Microbiol 2010;59:1260–1262 [CrossRef][PubMed]
    [Google Scholar]
  9. Hervio-Heath D, Colwell RR, Derrien A, Robert-Pillot A, Fournier JM et al. Occurrence of pathogenic vibrios in coastal areas of France. J Appl Microbiol 2002;92:1123–1135[PubMed][CrossRef]
    [Google Scholar]
  10. Pierce AB, Broughton SJ, Johnson PD, Grayson ML. Vibrio cholerae in Victoria. Med J Aust 2000;172:44–46
    [Google Scholar]
  11. Faruque SM, Albert MJ, Mekalanos JJ. Epidemiology, genetics, and ecology of toxigenic Vibrio cholerae. Microbiol Mol Biol Rev 1998;62:1301–1314
    [Google Scholar]
  12. Janda JM, Powers C, Bryant RG, Abbott SL. Current perspectives on the epidemiology and pathogenesis of clinically significant Vibrio spp. Clin Microbiol Rev 1988;1:245–267[CrossRef]
    [Google Scholar]
  13. Faruque SM, Asadulghani RMM, Waldor MK, Sack DA. Sunlight-induced propagation of the lysogenic phage encoding cholera toxin. Infect Immun 2000;68:4795–4801[CrossRef]
    [Google Scholar]
  14. Guhathakurta B, Sasmal D, Pal S, Chakraborty S, Nair GB et al. Comparative analysis of cytotoxin, hemolysin, hemagglutinin and exocellular enzymes among clinical and environmental isolates of Vibrio cholerae O139 and non-O1, non-O139. FEMS Microbiol Lett 1999;179:401–407[CrossRef]
    [Google Scholar]
  15. Chatterjee S, Ghosh K, Raychoudhuri A, Chowdhury G, Bhattacharya MK et al. Incidence, virulence factors, and clonality among clinical strains of non-O1, non-O139 Vibrio cholerae isolates from hospitalized diarrheal patients in Kolkata, India. J Clin Microbiol 2009;47:1087–1095[CrossRef]
    [Google Scholar]
  16. Zafari Y, Rahmanzadeh S, Zarifi AZ, Fakhar N. Diarrhoea caused by non-agglutinable Vibrio cholerae (non-cholera Vibrio). Lancet 1973;2:429–430[PubMed][CrossRef]
    [Google Scholar]
  17. Hughes JM, Hollis DG, Gangarosa EJ, Weaver RE. Non-cholera vibrio infections in the United States: clinical, epidemiologic, and laboratory features. Ann Intern Med 1978;88:602–606[PubMed][CrossRef]
    [Google Scholar]
  18. Blake PA, Weaver RE, Hollis DG, Humans D. Diseases of humans (other than cholera) caused by vibrios. Annu Rev Microbiol 1980;34:341–367[CrossRef]
    [Google Scholar]
  19. Eltahawy AT, Jiman-Fatani AA, Al-Alawi MM. A fatal non-01 Vibrio cholerae septicemia in a patient with liver cirrhosis. Saudi Med J 2004;25:1730–1731
    [Google Scholar]
  20. Lai CC, Liu WL, Chiu YH, Gau SJ, Hsueh PR. Spontaneous bacterial empyema due to non-O1, non-O139 Vibrio cholerae in a cirrhotic patient with hepatocellular carcinoma. Diagn Microbiol Infect Dis 2012;73:84–85[CrossRef]
    [Google Scholar]
  21. Luo Y, Ye J, Jin D, Ding G, Zhang Z et al. Molecular analysis of non-O1/non-O139 Vibrio cholerae isolated from hospitalised patients in China. BMC Microbiol 2013;13:52[CrossRef]
    [Google Scholar]
  22. Deshayes S, Daurel C, Cattoir V, Parienti JJ, Quilici ML et al. Non-O1, non-O139 Vibrio cholerae bacteraemia: case report and literature review. SpringerPlus 2015;4:575[CrossRef]
    [Google Scholar]
  23. Bautista JL, Budhraja MD, Barcia TD, Shankel SW. Pneumobilia associated with small-bowel obstruction. JAMA 1988;260:1930–1931[CrossRef]
    [Google Scholar]
  24. Lewandowski BJ, Withers C, Winsberg F. The air-filled left hepatic duct: the saber sign as an aid to the radiographic diagnosis of pneumobilia. Radiology 1984;153:329–332[CrossRef]
    [Google Scholar]
  25. Harley WD, Kirkpatrick RH, Ferrucci JT. Gas in the bile ducts (pneumobilia) in emphysematous cholecystitis. AJR Am J Roentgenol 1978;131:661–663[CrossRef]
    [Google Scholar]
  26. Sherman SC, Tran H. Pneumobilia: benign or life-threatening. J Emerg Med 2006;30:147–153[CrossRef]
    [Google Scholar]
  27. Bergman JJ, van Berkel AM, Groen AK, Schoeman MN, Offerhaus J et al. Biliary manometry, bacterial characteristics, bile composition, and histologic changes fifteen to seventeen years after endoscopic sphincterotomy. Gastrointest Endosc 1997;45:400–405[CrossRef]
    [Google Scholar]
  28. Ikeda S, Tanaka M, Matsumoto S, Yoshimoto H, Itoh H. Endoscopic sphincterotomy: long-term results in 408 patients with complete follow-up. Endoscopy 1988;20:13–17 [CrossRef][PubMed]
    [Google Scholar]
  29. Fearrington EL, Rand CH Jr, Mewborn A, Wilkerson J. Non-cholera vibrio septicemia and meningoencephalitis. Ann Intern Med 1974;81:401 [CrossRef][PubMed]
    [Google Scholar]
  30. Safrin S, Morris JG Jr, Adams M, Pons V, Jacobs R et al. Non-O:1 Vibrio cholerae bacteremia: case report and review. Rev Infect Dis 1988;10:1012–1017 [CrossRef][PubMed]
    [Google Scholar]
  31. Newman C, Shepherd M, Woodard MD, Chopra AK, Tyring SK. Fatal septicemia and bullae caused by non-01 Vibrio cholerae. J Am Acad Dermatol 1993;29:909–912 [CrossRef][PubMed]
    [Google Scholar]
  32. Lin CJ, Chiu CT, Lin DY, Sheen IS, Lien JM. Non-O1 Vibrio cholerae bacteremia in patients with cirrhosis: 5-yr experience from a single medical center. Am J Gastroenterol 1996;91:336–340[PubMed]
    [Google Scholar]
  33. Ko WC, Chuang YC, Huang GC, Hsu SY. Infections due to non-O1 Vibrio cholerae in southern Taiwan: predominance in cirrhotic patients. Clin Infect Dis 1998;27:774–780[PubMed][CrossRef]
    [Google Scholar]
  34. Rodríguez Ramos C, García Martos P, Galán Sánchez F, Soria de La Cruz MJ, Martín Herrera L. Spontaneous non-O1 Vibrio cholerae peritonitis after raw oyster ingestion in a patient with cirrhosis. Eur J Clin Microbiol Infect Dis 1998;17:362–363[PubMed]
    [Google Scholar]
  35. Chang-Chien CH. Bacteraemic necrotizing fasciitis with compartment syndrome caused by non-O1 Vibrio cholerae. J Plast Reconstr Aesthet Surg 2006;59:1381–1384[CrossRef]
    [Google Scholar]
  36. Yang CC, Lee BJ, Yang SS, Lin YH, Lee YL. A case of non-O1 and non-O139 Vibrio cholerae septicemia with endophthalmitis in a cirrhotic patient. Jpn J Infect Dis 2008;61:475–476[PubMed]
    [Google Scholar]
  37. Tsai YH, Huang TJ, Hsu RW, Weng YJ, Hsu WH et al. Necrotizing soft-tissue infections and primary sepsis caused by Vibrio vulnificus and Vibrio cholerae non-O1. J Trauma 2009;66:899–905 [CrossRef][PubMed]
    [Google Scholar]
  38. Morris JG, Wilson R, Davis BR, Wachsmuth IK, Riddle CF et al. Non-O group 1 Vibrio cholerae gastroenteritis in the United States: clinical, epidemiologic, and laboratory characteristics of sporadic cases. Ann Intern Med 1981;94:656–658[CrossRef]
    [Google Scholar]
  39. Cheasty T, Said B, Threlfall EJ. V cholerae non-O1: implications for man?. Lancet 1999;354:89–90[CrossRef]
    [Google Scholar]
  40. Dhar R, Badawi M, Qabazard Z, Albert MJ. Vibrio cholerae (non-O1, non-O139) sepsis in a child with Fanconi anemia. Diagn Microbiol Infect Dis 2004;50:287–289 [CrossRef][PubMed]
    [Google Scholar]
  41. Lan NP, Nga TV, Yen NT, Dung le T, Tuyen HT et al. Two cases of bacteriemia caused by nontoxigenic, non-O1, non-O139 Vibrio cholerae isolates in Ho Chi Minh City, Vietnam. J Clin Microbiol 2014;52:3819–3821 [CrossRef][PubMed]
    [Google Scholar]
  42. Dutta D, Chowdhury G, Pazhani GP, Guin S, Dutta S et al. Vibrio cholerae non-O1, non-O139 serogroups and cholera-like diarrhea, Kolkata, India. Emerg Infect Dis 2013;19:464–467 [CrossRef][PubMed]
    [Google Scholar]
  43. Chen YT, Tang HJ, Chao CM, Lai CC. Clinical manifestations of non-O1 Vibrio cholerae infections. PLoS One 2015;10:e0116904
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmmcr/10.1099/jmmcr.0.005077
Loading
/content/journal/jmmcr/10.1099/jmmcr.0.005077
Loading

Data & Media loading...

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error