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

We isolated non-O1, non-O139 Vibrio cholerae from pleural effusion in a patient with recurred advanced gastric caner after total gastrectomy. We also recovered the organism from the patient's stool culture. The patient did not experience gastrointestinal symptoms such as diarrhea except heartburn and epigastric discomfort from stomach cancer before admission. The suspected route of infection is directly from the gastrointestinal tract through the previous surgical wounds. After antibiotic treatment, no more V. cholerae was isolated and the patient was well discharged from the hospital. This is the first report of V. cholerae infection associated with pleural effusion in a long-term latent carrier of the organism.
Vibrio cholerae non-O1/*isolation & purification ; Stomach Neoplasms/microbiology/surgery ; Pleural Effusion/*microbiology ; Middle Aged ; Male ; Humans ; *Gastrectomy ; Carrier State

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

OBJECTIVETo study the distribution of serotype and the positive rate of toxins among vibrio cholerae non-O(1) isolated from environmental waters in Foshan city.

METHODSWater specimens were collected from river and cultured for vibrio cholerae non-O(1). The PCR method was used to detect cholerae enterotoxin (CT) gene; the ELISA method was used to detect heat-stable toxin (ST) and heat-labile toxin (LT).

RESULTS478 vibrio cholerae non-O(1) strains were isolated from 1 644 water specimens, with a positive rate of 29.07%. Serological assay showed that the main serotype of vibrio cholerae non-O(1) in Foshan city is VBO(7). Positive rate of CT, ST and LT were 1.91%, 13.14% and 12.17%, respectively.

CONCLUSIONSA few non-O(1) strains were found to have several virulent factors simultaneously, and the results suggest that vibrio cholerae non-O(1) in environmental waters is potentially pathogenic and may affect people's health. It is necessary to pay attention to the prevention of diarrhoea caused by vibrio cholerae.

China ; Enterotoxins ; genetics ; Environmental Monitoring ; methods ; Enzyme-Linked Immunosorbent Assay ; Polymerase Chain Reaction ; Seasons ; Serotyping ; Vibrio cholerae non-O1 ; classification ; genetics ; isolation & purification ; Water ; analysis ; Water Microbiology

Vibrio cholerae non-O1 have caused several well-studied food-borne outbreaks of gastroenteritis and also have been responsible for sporadic cases of otitis media, wound infection, and bacteremia. Few cases of liver abscess caused by Vibrio cholerae non-O1 have been reported. A 73-year-old man with underlying diabetes mellitus was admitted with nausea, vomiting, dyspepsia and febrile sensation. We identified Vibrio cholerae non-O1 in his blood cultures and multiple hepatic microabscess on abdominal computed tomography. He was treated with systemic antibiotics and fluid therapy, but died due to septic shock on sixth day. We report here, a case of liver abscess with bacteremia due to Vibrio cholerae non-O1 in a patient with diabetes mellitus.
Aged ; Anti-Bacterial Agents/therapeutic use ; Bacteremia/drug therapy/*microbiology ; Ceftriaxone/therapeutic use ; Humans ; Liver Abscess/*diagnosis/drug therapy/microbiology ; Male ; Metronidazole/therapeutic use ; Shock, Septic/diagnosis ; Tomography, X-Ray Computed ; Vibrio Infections/drug therapy/*microbiology ; Vibrio cholerae non-O1/*isolation & purification