BACKGROUND: Vibrio species may be classified as halophilic or nonhalophilic on the basis of their requirement of NaCl for optimal growth. Recently, attention has been focused on the halophilic vibrios and Vibrio cholerae non-O1/O139 causing extraintestinal infections such as septicemia. The aim of this study is to elucidate the isolation rate and clinical manifestations of Vibrio species isolated from clinical specimens between 1996 and 2000 at Wonju Christian Hospital. METHODS: Stool specimens were inoculated onto the thiosulfate-citrate-bile salt-sucrose media, blood cultures were performed by automated blood culture systems with commercial bottles, and the others were cultured according to the routine procedures. RESULTS: The isolation rate of Vibrio in decreasing order were: V. parahaemolyticus; 87%(62/71), V. alginolyticus; 6%(4/71), V. cholerae non-O1; 4%(3/71), and V. vulnificus; 3%(2/71). The proportions of gastroenteritis and septicemia by Vibrio species were 89% and 7%, respectively. Patients with gastroenteritis recovered without special problem, but the mortality of septicemia was 80%. CONCLUSIONS: Ninety-seven percentage of clinical isolates of Vibrio species were halophilic vibrios, and the mortality of Vibrio septicemia was as high as 80%.
Cholera ; Gangwon-do* ; Gastroenteritis ; Humans ; Mortality ; Sepsis ; Tertiary Healthcare* ; Vibrio cholerae ; Vibrio Infections* ; Vibrio*

Vibrio cholerae non-O1 mainly causes gastroenteritis and rarely causes extraintestinal infections, such as bacteremia. Skin and soft tissue infections are also possible, but the incidence rate is very low. Although the most common cause of pyomyositis is Staphylococcus aureus, Gram-negative organisms such as Vibrio species may also cause pyomyositis in patients with chronic liver disease. Pyomyositis caused by Vibrio cholerae non-O1 has not been reported in Korea. Here, we report a case of pyomyositis caused by V. cholerae non-O1 bacteremia in a patient with liver cirrhosis following seafood exposure. This case study suggests that V. cholerae, as well as V. vulnificus, should be considered when soft tissue infections occur in patients with liver cirrhosis after seafood exposure. In addition, physicians should consider imaging studies for a prompt diagnosis if the patient complains of severe pain disproportionate to the skin manifestation.
Bacteremia ; Cholera ; Gastroenteritis ; Humans ; Incidence ; Korea ; Liver ; Liver Cirrhosis ; Liver Diseases ; Pyomyositis ; Seafood ; Skin ; Skin Manifestations ; Soft Tissue Infections ; Staphylococcus aureus ; Vibrio ; Vibrio cholerae ; Vibrio cholerae non-O1

Murine caspase-11 is orthologus to human caspase-4 and caspase-5, and is required for the response to cholera toxin B and infection with Escherichia coli, Citrobacter rodentium or Vibrio cholerae. Caspase-11 rather than caspase-1 is the main offender involved in sepsis. Hence, caspase-11 plays an essential pro-inflammatory role in innate immune response to bacterial infections.
Bacterial Infections ; Cholera Toxin ; Citrobacter rodentium ; Criminals ; Escherichia coli ; Humans ; Immunity, Innate ; Sepsis ; Vibrio cholerae

Non-O1, non-O139 Vibrio cholerae usually causes gastroenteritis and bacteremia. It can also cause skin and soft tissue infection but the incidence is very rare. Patients who have been reported to have skin and soft tissue infection caused by non-O1, non-O139 V. cholerae had liver cirrhosis or chronic hepatitis. We present here a case of skin and soft tissue infection caused by non-O1, non- O139 V. cholerae in a patient with liver cirrhosis in Korea. After treatment of cefotaxime, doxycycline and debridement, the wound was clinically improved. This case suggests that non-O1, non-O139 V. cholerae infection should also be considered in addition to V. vulnificus infection when skin and soft tissue infections occurs in patients with liver cirrhosis, especially if they have had seawater or seafood exposure.
Bacteremia ; Cefotaxime ; Cholera ; Debridement ; Doxycycline ; Gastroenteritis ; Hepatitis, Chronic ; Humans ; Incidence ; Korea ; Liver Cirrhosis* ; Liver* ; Seafood ; Seawater ; Skin* ; Soft Tissue Infections* ; Vibrio cholerae* ; Vibrio* ; Wounds and Injuries

Non-O1, non-O139 Vibrio cholerae usually causes gastroenteritis and bacteremia. It can also cause skin and soft tissue infection but the incidence is very rare. Patients who have been reported to have skin and soft tissue infection caused by non-O1, non-O139 V. cholerae had liver cirrhosis or chronic hepatitis. We present here a case of skin and soft tissue infection caused by non-O1, non- O139 V. cholerae in a patient with liver cirrhosis in Korea. After treatment of cefotaxime, doxycycline and debridement, the wound was clinically improved. This case suggests that non-O1, non-O139 V. cholerae infection should also be considered in addition to V. vulnificus infection when skin and soft tissue infections occurs in patients with liver cirrhosis, especially if they have had seawater or seafood exposure.
Bacteremia ; Cefotaxime ; Cholera ; Debridement ; Doxycycline ; Gastroenteritis ; Hepatitis, Chronic ; Humans ; Incidence ; Korea ; Liver Cirrhosis* ; Liver* ; Seafood ; Seawater ; Skin* ; Soft Tissue Infections* ; Vibrio cholerae* ; Vibrio* ; Wounds and Injuries

A 63-year-old man with underlying liver cirrhosis was admitted with painful swelling of the right thigh. We identified a non-O1 Vibrio cholerae strain in blood cultures and multiple pyomyositis in the lower limbs. Non-O1 V. cholerae strains have caused several well-studied food-borne outbreaks of gastroenteritis and have been responsible for sporadic cases of otitis media, skin and soft tissue infection, and bacteremia. Skin and soft tissue infection due to non-O1 V. cholerae is rare and is commonly associated with the presence of chronic underlying disease, such as liver cirrhosis, diabetes mellitus, an immunocompromised state, or a hematological malignancy. We report the first case of pyomyositis caused by non-O1 V. cholerae in Korea. Physicians should consider non-O1 V. cholerae strains as a pathogen that can cause pyomyositis.
Bacteremia ; Cholera ; Diabetes Mellitus ; Disease Outbreaks ; Gastroenteritis ; Hematologic Neoplasms ; Humans ; Korea ; Liver ; Liver Cirrhosis ; Lower Extremity ; Middle Aged ; Otitis Media ; Pyomyositis ; Skin ; Soft Tissue Infections ; Sprains and Strains ; Thigh ; Vibrio ; Vibrio cholerae ; Vibrio cholerae non-O1

Ginsan, a botanic polysaccharide extracted from Panax ginseng, has recently been reported to modulate mucosal immune response. In this study, we investigated the protective effect of Ginsan against fatal Vibrio vulnificus mucosal infection. A lethal dose of V. vulnificus (1.0 x 106 CFU/mouse) was nasally inoculated to mice. The bacterial count in the nasal associated lymphoid tissue (NALT) of the mouse was significantly reduced in the Ginsan-treated group. The Ginsan-treated group showed improved survival compared to the control group (100% vs 18%). To elucidate the effect of Ginsan on modulating host immune response, cytokine mRNA expressions involved in mediating inflammation were determined by semiquantitative RT-PCR in the NALTs of the infected mice. Most of the cytokine mRNAs were similarly expressed as the control group. However, COX-1 mRNA expression level was higher in Ginsan-treated group compared to the control group. The protective effect of Ginsan was antagonized by treating with a specific COX-1 inhibitor, SC-560. Thus, these data suggest that the protective effect of Ginsan against V. vulnificus infection is partly mediated by modulating COX-1 expression.
Animals ; Bacterial Load ; Immunity, Mucosal ; Inflammation ; Lymphoid Tissue ; Mice ; Negotiating ; Panax ; Polysaccharides ; Pyrazoles ; RNA, Messenger ; Vibrio ; Vibrio Infections ; Vibrio vulnificus

Vibrio vulnificus was isolated from a blood culture of a 41-year-old male patient with liver cirrhosis. He had eaten raw fish one day prior to the onset of clinical symptoms which included fever, chills, diarrhea and hypotension. He also developed cellulitis of the right leg which developed into a necrotic ulcer. The isolate was a slightly curved gram-negative bacillus and the colony morphology on a TCBS plate was similar to that of V. parabaemolyticus. Acid production from lactose was detected after 2 days of incubation. Other biochemical tests showed typical reactions of V vulnificus. The isolate was susceptible to all of the tested antibiotics except to clindamycin, colistin and penicillin G.
Adult ; Human ; Liver Cirrhosis/complications* ; Male ; Microscopy, Electron ; Septicemia/microbiology* ; Vibrio/isolation & purification ; Vibrio/ultrastructure ; Vibrio Infections/microbiology*

Vibrio vulnificus causes very severe infections. The organism is isolated, for the most part, from the blood, and skin lesions. Isolation from other sources, including the urine, is very rate. Four cases of V. vulnificus septicemia were bacteriologically diagnosed in 1984 and 1985 at Severance Hospital. All of the patients were men, 42 years and older, with preexisting liver disease. All of them showed hypotension and secondary skin lesions, and all expired. The organism was isolated from the blood in all patients, from the peritoneal fluid in one, and from skin lesions in two. From one patient, isolation from a urine speAmen was also accomplished. All of the isolates were typical in their characteristics such as in their forming green colonies on Thiosulfate citrate bile sucrose (TCBS) agar, delayed acid production from lactose, and growth in broth with 6% NaCl.
Adult ; Human ; Middle Age ; Septicemia/diagnosis* ; Vibrio/isolation & purification ; Vibrio Infections/diagnosis*

PURPOSE: To report a case of endophthalmitis associated with Vibrio vulnificus septicemia. METHODS: Vibrio vulnificus septicemia patient was referred to us in consultation for abrupt onset left visual loss, severe periorbital swelling and conjunctival injection. RESULTS: Left eye showed suppurative intraocular inflammation. With a clinical impression of V. vulnificus endogeneous endophthalmitis, culture for causative organisms and intravitreal antibiotics injection were done. Two days later, we performed pars plana lensectomy, pars plana vitrectomy, intravitreal antibiotics, SF6 gas injection. Intraocular inflammation was subsided after operation, and the anatomical structure of the eyeball was preserved CONCLUSIONS: Immediate ophthalmologic examination is mandatory for ruling out endophthalmitis when Vibrio species septicemia patient complains of ophthalmic symptoms, such as blurred vision or ocular pain. When clinicians diagnose endophthalmitis, make an effort to identify causative organisms. When bacterial infection is suspected, inject antibiotics intravitreously or vitrectomy must be done as faster as possible.
Anti-Bacterial Agents ; Bacterial Infections ; Endophthalmitis* ; Humans ; Inflammation ; Intravitreal Injections ; Sepsis* ; Vibrio ; Vibrio vulnificus ; Vitrectomy