Fatal Diarrheal Disease Caused by <i>Vibrio cholerae</i> O67 in a Patient with Myelodysplastic Syndrome

Abstract

A 71-year-old man with myelodysplastic syndrome (MDS) receiving treatment with azacitidine developed extensive watery diarrhea for three consecutive days. As a result of high-grade dehydration, the patient was urgently admitted to the hospital and fluid replacement therapy was initiated. However, the patient's diarrhea did not improve. Vibrio cholerae non-O1/non-O139 was detected in a fecal culture. On the fourth day, the patient died due to circulatory collapse. An autopsy revealed extensive necrosis of the intestinal mucosa. Vibrio cholerae non-O1/non-O139-induced diarrheal disease often develops in patients with hepatic cirrhosis and has a serious clinical course. We herein report a fatal outcome of Vibrio cholerae O67 infection in an immunocompromised MDS patient.

Virulence-associated genes and molecular characteristics of non-O1/non-O139 Vibrio cholerae isolated from hepatitis B cirrhosis patients in China

“…Possible reasons could be pre-existing disruption of mucosal barrier, achlorhydria, simultaneous infection with an invasive pathogen, translocation of viable V. cholerae via M cells and hemolysin production (Jabeen et al, 2010). The predisposing factor was often raw or uncooked seafood consumption, exposure of wounds to seawater as well as drinking impure water (Marinello et al, 2017;Lukinmaa et al, 2006;Tamura et al, 2013). The patients in our study were clearly diagnosed with hepatitis B cirrhosis, which is consistent with the susceptibility factors of V. cholerae infection.…”