The Characterization of Vibrio cholerae Non-O1 Strain Causing Perforative Pan-peritonitis

Abstract

We report a case of a 53-year-old male with Vibrio cholerae non-O1 (serotype O19) infection, resulting in perforative pan-peritonitis. The patient had a history of gastric cancer and a gastrectomy was performed one year prior. The patient had previously been admitted with nausea and vomiting and was diagnosed with a sub-ileus condition. He was provisionally discharged when his condition improved and during that period he ate raw fish caught locally in Nagasaki Prefecture, and several hours later he experienced a sudden onset of severe abdominal pain and nausea and on diagnosis of pan-peritonitis an emergency resection of the transverse colon was performed. We subsequently isolated Vibrio cholerae non-O1 from the patient's peritoneal fluid and stool. He died of multiple organ failure three weeks later despite intensive chemotherapeutic care and treatment for shock and disseminated intravascular coagulation. The strain of Vibrio cholerae non-O1 isolated was non-toxigenic but hemolytic with hyper-producing of metalloprotease.

Distribution of Virulence Genes in Clinical and Environmental Vibrio cholerae Strains in Bangladesh

“…For 30 years, they have been associated with septicemia (4, 5), peritonitis (6), and gastroenteritis (7)(8)(9), via ingestion of contaminated food or exposure to the aquatic environment. Similarly, nontoxigenic Vibrio cholerae O1 has been linked to gastroenteritis (10) and localized cholera outbreaks (11).…”

Vibrio cholerae Bacteraemia: Report of Two Cases

“…The consumption of undercooked or raw marine live species, drinking contaminated water, and exposure of wounds to contaminated salts and water, can lead to an acute diarrheal disease called 'cholera' caused by Vibrio cholerae. This disease is also found in patients suffering from cirrhosis and ascites, renal failure and in haematological malignancies [1][2][3]. Cholera is primarily a gastrointestinal disease.…”

Fatal bacteremia due to immotile Vibrio cholerae serogroup O21 in Vientiane, Laos – a case report

“…Non cholera-toxin producing, non-O1, non-O139 V. cholerae have been described from blood cultures and ascitic fluid, although they are exceedingly rare isolates. Consumption of undercooked shellfish, exposure of open wounds to salt and fresh water, drinking of well water, ascites, cirrhosis, renal failure and haematological malignancies have all been associated with non-O1, non-O139 disease [ 3 - 5 ]. The mortality of recorded non-O1 bacteraemia is high at 24–62% [ 6 - 11 ].…”