Non-O1, non-O139 Vibrio cholerae bacteraemia: case report and literature review

Abstract

Non-O1, non-O139 Vibrio cholerae (NOVC) are increasingly frequently observed ubiquitous microorganisms occasionally responsible for intestinal and extra-intestinal infections. Most cases involve self-limiting gastroenteritis or ear and wound infections in immunocompetent patients. Bacteraemia, which have been described in patients with predisposing factors, are rare and poorly known, both on the clinical and therapeutic aspects. We describe a case of NOVC bacteraemia and a systematic literature review in PubMed conducted up to November 2014 using a combination of the following search terms: "Vibrio cholerae non-O1" and "bacter(a)emia". The case was a 70 year-old healthy male subject returning from Senegal and suffering from NOVC bacteraemia associated with liver abscesses. Disease evolution was favourable after 2 months' therapy (ceftriaxone then ciprofloxacin). Three hundred and fifty cases of NOVC bacteraemia have been identified in the literature. The majority of patients were male (77 %), with a median age of 56 years and presenting with predisposing conditions (96 %), such as cirrhosis (55 %) or malignant disease (20 %). Diarrhoea was inconstant (42 %). Mortality was 33 %. The source of infection, identified in only 25 % of cases, was seafood consumption (54 %) or contaminated water (30 %). Practitioners should be aware of these infections, in order to warn patients with predisposing conditions, on the risk of ingesting raw or undercooked seafood or bathing in potentially infected waters.

Keywords: Abscess; Bacteraemia; Non-O1 Vibrio cholerae.

Fig. 1

Abdominal CT showing two low density lesions in the right liver (arrows), compatible with the diagnosis of liver abscesses

Fig. 2

a Gram stain (magnificence ×1000) and b colonial morphology of non-O1, non-O139 V. cholerae grown on Trypticase-Soy agar after 18 h of aerobic incubation at 35 °C (Photos M. Auzou)