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Homsy P, Skogberg K, Jahkola T. Three cases of fulminant cellulitis caused by non-O1, non-O139 Vibrio cholerae in Southern Finland. Infect Dis (Lond) 2020; 52:506-510. [PMID: 32324089 DOI: 10.1080/23744235.2020.1756399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Background: Non-O1, non-O139 Vibrio cholerae is endemic in temperate waters. Most often encountered as the pathogen in transient gastroenteritis, it can also cause severe soft tissue infections. While normally a rare pathogen in Finland, we observed seven cases of non-O1, non-O139 V. cholerae infections in Helsinki University Hospital during the hot summer of 2018. Here we present three of these cases with fulminant V. cholerae cellulitis in detail.Methods: Patients with tissue culture positive soft tissue infections between 2017 and 2019 were identified using a local laboratory database. Patients with severe infections requiring surgical revision were included in this series.Results: Three patients with tissue culture positive non-O1, non-O139 V. cholerae cellulitis were identified. All were treated in the summer of 2018 for fulminant lower leg cellulitis. Two patients were febrile and hemodynamically unstable at presentation. One had septicaemia. Surgical revisions were done within the first week of admission, and defects covered with partial-thickness skin grafts several weeks later. Antibiotic treatment varied and continued until the wounds were healed, between one and over two months in total.
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Affiliation(s)
- Pauliina Homsy
- Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kirsi Skogberg
- Department of Infections Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tiina Jahkola
- Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Piper betel Compounds Piperidine, Eugenyl Acetate, and Chlorogenic Acid Are Broad-Spectrum Anti- Vibrio Compounds that Are Also Effective on MDR Strains of the Pathogen. Pathogens 2019; 8:pathogens8020064. [PMID: 31086061 PMCID: PMC6631886 DOI: 10.3390/pathogens8020064] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 04/30/2019] [Accepted: 05/07/2019] [Indexed: 12/25/2022] Open
Abstract
The natural population of the aquatic environment supports a diverse aquatic biota and a robust seafood industry. However, this environment also provides an appropriate niche for the growth of pathogenic bacteria that cause problems for human health. For example, species of the genus Vibrio inhabit marine and estuarine environments. This genus includes species that are pathogenic to aquaculture, invertebrates, and humans. In humans, they can cause prominent diseases like gastroenteritis, wound infections, and septicemia. The increased number of multidrug resistant (MDR) Vibrio strains has drawn the attention of the scientific community to develop new broad-spectrum antibiotics. Hence, in this paper we report the bactericidal effects of compounds derived from Piper betel plants: piperidine, chlorogenic acid, and eugenyl acetate, against various strains of Vibrio species. The different MIC90 values were approximately in a range of 2–6 mg/mL, 5–16 mg/mL, 5–20 mg/mL, and 30–80 mg/mL, for piperidine, chlorogenic acid, and eugenyl acetate, respectively. Piperidine showed the best anti-Vibrio effect against the five Vibrio species tested. Interestingly, combinations of sub-inhibitory concentrations of piperidine, chlorogenic acid, and eugenyl acetate showed inhibitory effects in the Vibrio strains. Furthermore, these compounds showed synergism or partial synergism effects against MDR strains of the Vibrio species when they were incubated with antibiotics (ampicillin and chloramphenicol).
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Engel MF, Muijsken MA, Mooi-Kokenberg E, Kuijper EJ, van Westerloo DJ. Vibrio cholerae non-O1 bacteraemia: description of three cases in the Netherlands and a literature review. ACTA ACUST UNITED AC 2017; 21:30197. [PMID: 27104237 DOI: 10.2807/1560-7917.es.2016.21.15.30197] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 01/22/2016] [Indexed: 11/20/2022]
Abstract
Vibrio cholerae non-O1 serogroup (VCNO) bacteraemia is a severe condition with a high case-fatality rate. We report three cases diagnosed in the Netherlands, identified during a national microbiological congress, and provide a literature review on VCNO bacteraemia. A search strategy including synonyms for 'VCNO' and 'bacteraemia' was applied to PubMed, Medline, Web of Science and Embase databases. The three cases were reported in elderly male patients after fish consumption and/or surface water contact. The literature search yielded 82 case reports on 90 cases and six case series. Thirty case reports were from Asia (30/90; 33%), concerned males (67/90; 74%), and around one third (38/90; 42%) involved a history of alcohol abuse and/or liver cirrhosis The presenting symptom often was gastroenteritis (47/90; 52%) which occurred after seafood consumption in 32% of the cases (15/47).Aside from the most frequent symptom being fever, results of case series concurred with these findings. Published cases also included rare presentations e.g. endophthalmitis and neonatal meningitis. Based on the limited data available, cephalosporins seemed the most effective treatment. Although mainly reported in Asia, VCNO bacteraemia occurs worldwide. While some risk factors for VCNO were identified in this study, the source of infection remains often unclear. Clinical presentation may vary greatly and therefore a quick microbiological diagnosis is indispensable.
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Affiliation(s)
- Madelon F Engel
- Medical Microbiology Department, Leiden University Medical Centre, Leiden, the Netherlands
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4
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Maraki S, Christidou A, Anastasaki M, Scoulica E. Non-O1, non-O139 Vibrio cholerae bacteremic skin and soft tissue infections. Infect Dis (Lond) 2015; 48:171-6. [PMID: 26503346 DOI: 10.3109/23744235.2015.1104720] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Non-O1, non-O139 Vibrio cholerae can cause sporadic cases of gastroenteritis and extra-intestinal invasive infections, following exposure to contaminated seawater or freshwater or after consumption of raw seafood. Bacteremic infections with skin and soft tissue manifestations are uncommon and in most cases are associated with liver cirrhosis, haematologic malignancies, diabetes mellitus and other immunosuppressed conditions. METHODS The medical literature was reviewed and we found 47 published cases of non-O1, non-O139 Vibrio cholerae bacteremic skin and soft tissue infections. A fatal case of bacteremia with bullous cellulitis in a 43-year-old patient with liver cirrhosis is described, which is the first reported in Greece. RESULTS From January 1974 to May 2015, a total of 48 patients with non-O1, non-O139 Vibrio cholerae bacteremia with skin and soft tissue infections were reported. Males predominated. Liver cirrhosis, chronic liver disease and alcohol abuse were common comorbidities. The soft tissue lesions most commonly described were localised cellulitis, with or without bullous and haemorrhagic lesions (66.7%), while necrotising fasciitis was more rare (29.2%). Of the 48 patients with non-O1, non-O139 V. cholerae bacteremic skin and soft tissue infections, 20 (41.7%) died despite treatment. CONCLUSION Although rarely encountered, non-O1, non-O139 Vibrio cholerae should be included in the differential diagnosis of bacteremic skin and soft tissue infections in patients with underlying illnesses and epidemiologic risk factors. Timely and appropriate antibiotic and surgical treatments are important in the management of the infection.
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Affiliation(s)
- Sofia Maraki
- a Department of Clinical Microbiology , Parasitology, Zoonoses and Geographical Medicine
| | - Athanasia Christidou
- a Department of Clinical Microbiology , Parasitology, Zoonoses and Geographical Medicine
| | - Maria Anastasaki
- b Intensive Care Medicine Department , University Hospital of Heraklion , Crete , Greece
| | - Efstathia Scoulica
- c Laboratory of Clinical Bacteriology and Molecular Microbiology , School of Medicine, University of Crete , Heraklion , Crete , Greece
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5
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Deshayes S, Daurel C, Cattoir V, Parienti JJ, Quilici ML, de La Blanchardière A. Non-O1, non-O139 Vibrio cholerae bacteraemia: case report and literature review. SPRINGERPLUS 2015; 4:575. [PMID: 26543710 PMCID: PMC4627963 DOI: 10.1186/s40064-015-1346-3] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 09/16/2015] [Indexed: 01/12/2023]
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.
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Affiliation(s)
- S Deshayes
- Service des Maladies Infectieuses et Tropicales, CHU Côte de Nacre, avenue Côte de Nacre, 14033 Caen Cedex 9, France
| | - C Daurel
- Service de Microbiologie, CHU Côte de Nacre, avenue Côte de Nacre, 14033 Caen Cedex 9, France
| | - V Cattoir
- Service de Microbiologie, CHU Côte de Nacre, avenue Côte de Nacre, 14033 Caen Cedex 9, France
| | - J-J Parienti
- Service des Maladies Infectieuses et Tropicales, CHU Côte de Nacre, avenue Côte de Nacre, 14033 Caen Cedex 9, France ; Unité de Biostatistiques, CHU Côte de Nacre, avenue Côte de Nacre, 14033 Caen Cedex 9, France
| | - M-L Quilici
- Centre National de Référence des Vibrions et du Choléra, Institut Pasteur, 28 rue du Docteur Roux, 75724 Paris Cedex 15, France
| | - A de La Blanchardière
- Service des Maladies Infectieuses et Tropicales, CHU Côte de Nacre, avenue Côte de Nacre, 14033 Caen Cedex 9, France
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Khan S, Kumar A, Meparambu D, Thomas S, Harichandran D, Karim S. Fatal non-O1, non-O139 Vibrio cholerae septicaemia in a patient with chronic liver disease. J Med Microbiol 2013; 62:917-921. [DOI: 10.1099/jmm.0.049296-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
A 49-year-old male with underlying liver disease presented with fever and signs of sepsis. Non-O1/non-O139 Vibrio cholerae was isolated from his blood culture, which was positive for the hlyA and toxR genes. We report this fatal case of non-O1/non-O139 V. cholera sepsis and review the literature on non-O1/non-O139 V. cholerae sepsis in patients with chronic liver disease.
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Affiliation(s)
- Sadia Khan
- Department of Microbiology, Amrita Institute of Medical Sciences, Ponekara, Kochi-682041, Kerala, India
| | - Anil Kumar
- Department of Microbiology, Amrita Institute of Medical Sciences, Ponekara, Kochi-682041, Kerala, India
| | - Divya Meparambu
- Cholera and Environmental Biology Laboratory, Dept of Molecular Microbiology Rajiv Gandhi Center for Biotechnology Trivandrum, Kerala, India
| | - Sabu Thomas
- Cholera and Environmental Biology Laboratory, Dept of Molecular Microbiology Rajiv Gandhi Center for Biotechnology Trivandrum, Kerala, India
| | - Deepa Harichandran
- Department of Microbiology, Amrita Institute of Medical Sciences, Ponekara, Kochi-682041, Kerala, India
| | - Shamsul Karim
- Department of Microbiology, Amrita Institute of Medical Sciences, Ponekara, Kochi-682041, Kerala, India
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Petsaris O, Nousbaum JB, Quilici ML, Le Coadou G, Payan C, Abalain ML. Non-O1, non-O139 Vibrio cholerae bacteraemia in a cirrhotic patient. J Med Microbiol 2010; 59:1260-1262. [PMID: 20616193 DOI: 10.1099/jmm.0.021014-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Vibrio cholerae serogroups O1 or O139 are the aetiological agents of cholera. The pathogenicity of non-O1, non-O139 V. cholerae is less well known. These worldwide bacteria are responsible for gastrointestinal infections or, more rarely, bacteraemia in patients with an underlying disease, leading to life-threatening complications. We report a case of non-O1, non-O139 V. cholerae bacteraemia due to a haemolytic strain in a cirrhotic patient. Early antibiotherapy allowed a good outcome. The aim of this case report is to underline the virulence of non-choleragenic Vibrio strains, possibly linked to haemolysin production, and the potential danger of consuming undercooked seafood or exposing wounds to sea water in cirrhotic patients.
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Affiliation(s)
- O Petsaris
- Faculté de Médecine et des Sciences de la Santé, Université de Brest, EA 3882, 29200 Brest, France.,Laboratoire de Microbiologie, Centre Hospitalier Universitaire La Cavale Blanche, Boulevard Tanguy Prigent, 29609 Brest cedex, France
| | - J B Nousbaum
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire la Cavale Blanche, 29609 Brest cedex, France
| | - M L Quilici
- Centre National de Référence des Vibrions et du Choléra, Institut Pasteur, 75724 Paris cedex 15, France
| | - G Le Coadou
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire la Cavale Blanche, 29609 Brest cedex, France
| | - C Payan
- Faculté de Médecine et des Sciences de la Santé, Université de Brest, EA 3882, 29200 Brest, France.,Laboratoire de Microbiologie, Centre Hospitalier Universitaire La Cavale Blanche, Boulevard Tanguy Prigent, 29609 Brest cedex, France
| | - M L Abalain
- Faculté de Médecine et des Sciences de la Santé, Université de Brest, EA 3882, 29200 Brest, France.,Laboratoire de Microbiologie, Centre Hospitalier Universitaire La Cavale Blanche, Boulevard Tanguy Prigent, 29609 Brest cedex, France
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8
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Phetsouvanh R, Nakatsu M, Arakawa E, Davong V, Vongsouvath M, Lattana O, Moore CE, Nakamura S, Newton PN. Fatal bacteremia due to immotile Vibrio cholerae serogroup O21 in Vientiane, Laos - a case report. Ann Clin Microbiol Antimicrob 2008; 7:10. [PMID: 18439249 PMCID: PMC2373308 DOI: 10.1186/1476-0711-7-10] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2007] [Accepted: 04/25/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Human infections with non-O1, non-O139 V. cholerae have been described from Laos. Elsewhere, 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. CASE PRESENTATION We describe a farmer who died with Vibrio cholerae O21 bacteremia and peritonitis in Vientiane, Laos, after eating partially cooked apple snails (Pomacea canaliculata) and mussels (Ligumia species). The cultured V. cholerae were non-motile. PCR detected ompW and toxR gene regions but not the ctxA, ompU, omp K and TCP gene regions. Although the organisms lacked flagellae on scanning electron microscopy, they possessed the Vibrio flagellin flaA gene. CONCLUSION Severe bacteremic non-O1, non-O139 V. cholerae is reported from Laos. The organisms were unusual in being non-motile. They possessed the Vibrio flagellin flaA gene. Further research to determine the reasons for the non-motility and virulence is required.
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Affiliation(s)
- Rattanaphone Phetsouvanh
- Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PD.
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Sánchez-Olmedo JI, Fajardo López-Cuervo J, García-Díaz F, Villanueva-Serrano S. Sepsis grave y celulitis por Vibrio cholerae no 01 en un paciente inmunocompetente. Med Clin (Barc) 2005; 125:717. [PMID: 16324488 DOI: 10.1016/s0025-7753(05)72164-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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10
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Haines GK, Sayed BA, Rohrer MS, Olivier V, Satchell KJF. Role of toll-like receptor 4 in the proinflammatory response to Vibrio cholerae O1 El tor strains deficient in production of cholera toxin and accessory toxins. Infect Immun 2005; 73:6157-64. [PMID: 16113340 PMCID: PMC1231125 DOI: 10.1128/iai.73.9.6157-6164.2005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Following intranasal inoculation, Vibrio cholerae KFV101 (DeltactxAB DeltahapA DeltahlyA DeltartxA) colonizes and stimulates tumor necrosis factor alpha and interleukin 1beta (IL-1beta) in mice, similar to what occurs with isogenic strain P4 (DeltactxAB), but is less virulent and stimulates reduced levels of IL-6, demonstrating a role for accessory toxins in pathogenesis. Morbidity is enhanced in C3H/HeJ mice, indicating that Toll-like receptor 4 is important for infection containment.
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Affiliation(s)
- G Kenneth Haines
- Northwestern University, Dept. of Microbiology-Immunology, 303 E. Chicago Avenue, Tarry 3-713, Chicago, IL 60611, USA
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11
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Satchell KJF. Activation and suppression of the proinflammatory immune response by Vibrio cholerae toxins. Microbes Infect 2003; 5:1241-7. [PMID: 14623020 DOI: 10.1016/j.micinf.2003.08.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Vibrio cholerae induces either non-inflammatory diarrhea or inflammatory gastroenteritis, depending on the presence of cholera toxin, a fluid secretion inducer and a modulator of host immunity. In the absence of cholera toxin, other toxins induce inflammation, resulting in gastroenteritis. Thus, multiple toxins likely affect the safety of live attenuated vaccines.
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Affiliation(s)
- Karla J Fullner Satchell
- Department of Microbiology-Immunology, Northwestern University Feinberg School of Medicine, 303 East Chicago Avenue, Morton 6-626, Chicago, IL 60611,USA.
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12
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Choi SM, Lee DG, Kim MS, Park YH, Kim YJ, Lee S, Kim HJ, Choi JH, Yoo JH, Kim DW, Min WS, Shin WS, Kim CC. Bacteremic cellulitis caused by non-O1, non-O139 Vibrio cholerae in a patient following hematopoietic stem cell transplantation. Bone Marrow Transplant 2003; 31:1181-2. [PMID: 12796802 DOI: 10.1038/sj.bmt.1704044] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Many newly described or "re-emerging" infectious diseases may present to the dermatologist, often with potentially life-threatening implications. Prompt recognition and early intervention can greatly diminish the morbidity and mortality associated with these diseases.
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Affiliation(s)
- S M Manders
- Division of Dermatology, University of Medicine and Dentistry, New Jersey-Robert Wood Johnson Medical School at Camden, Camden, New Jersey, USA.
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14
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Norton R, Vucak M, Stalewski H. Vibrio cholerae non-O1 facial cellulitis in a North Queensland, Australian child. Pediatr Infect Dis J 2001; 20:550-1. [PMID: 11368121 DOI: 10.1097/00006454-200105000-00020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Vibrio cholerae is an uncommon cause of cellulitis in Australia. Most reported cases worldwide have involved marine or brackish water contact. A recognized risk factor for acquiring this infection is chronic liver disease secondary to hepatitis B. We describe a case of extensive facial cellulitis caused by Vibrio cholerae non-O1, non-0139, in an 11-year-old indigenous girl from North Queensland, Australia, who was hepatitis B surface antigen-negative. Treatment consisted of extensive debridement, antibiotics, hyperbaric oxygen and facial reconstructive surgery. Early microbiologic diagnosis and a combined therapeutic approach are important in the management of this condition.
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Affiliation(s)
- R Norton
- Department of Clinical Microbiology, Townsville General Hospital, Queensland, Australia
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15
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Fernández JM, Serrano M, De Arriba JJ, Sánchez MV, Escribano E, Ferreras P. Bacteremic cellulitis caused by Non-01, Non-0139 Vibrio cholerae: report of a case in a patient with hemochromatosis. Diagn Microbiol Infect Dis 2000; 37:77-80. [PMID: 10794945 DOI: 10.1016/s0732-8893(99)00153-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We report a case of bacteremia associated with hemorrhagic bullous skin lesions on the leg caused by non-01, non-0139 Vibrio cholerae in a 66-year-old man with hemochromatosis developed in an inland region. The organism was isolated from blood and bullae fluid. The patient was treated successfully with cefotaxime and doxycycline. This report emphasizes the potential of this organism to produce bacteremic cellulitis in people with underlying illness in the absence of usual epidemiological risk factors.
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Affiliation(s)
- J M Fernández
- Department of Internal Medicine, Albacete General Hospital, c/Hermanos Falco n/n 02006, Albacete, Spain
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West BC, Silberman R, Otterson WN. Acalculous cholecystitis and septicemia caused by non-O1 Vibrio cholerae: first reported case and review of biliary infections with Vibrio cholerae. Diagn Microbiol Infect Dis 1998; 30:187-91. [PMID: 9572025 DOI: 10.1016/s0732-8893(97)00235-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The first case of septicemic acute acalculous cholecystitis caused by non-O1 Vibrio cholerae is described in a healthy traveler, and biliary tract infections from V. cholerae are reviewed. Immediately after a vacation in Cancun, Mexico, a 55-year-old man developed acute cholecystitis. Blood and bile cultures grew non-O1 V. cholerae. At surgery, the gallbladder was acalculous, inflamed, distended, and nearly ruptured. Pathogenetic factors may have included diarrhea prophylaxis with bismuth subsalicylate, distension of the gallbladder from illness-induced fasting, and bacterial toxins in the gallbladder. The patient received i.v. cephapirin, followed by oral cephradine for a total of 10 days, and he made a quick and complete recovery. V. cholerae should be considered in the differential diagnosis of persons from endemic areas who present with cholecystitis or acute jaundice.
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Affiliation(s)
- B C West
- Department of Medicine, Meridia Huron Hospital, Cleveland, OH 44112, USA
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