Non-O1/non-O139 Vibrio cholerae septicaemia in a Saudi man: a case report

Abstract

<b>Background.</b> The non-O1/non-O139 serogroups of <i>Vibrio cholerae</i> occur in diverse natural niches, and usually cause mild and self-limiting gastrointestinal illness. However, they have well-documented potential to cause invasive and extra-intestinal infections among immunocompromised patients. Furthermore, their ability to grow in low-salinity surface water, and the existence of asymptomatic human carriers, suggest novel acquisition routes for this unusual infection, even in people without obvious risk factors. <b>Case presentation.</b> A 62-year-old man presented with epigastric pain, vomiting and fever. The patient had a history of diabetes and cholecystectomy, although our initial examination did not reveal any significant findings that might indicate <i>V. cholerae</i> infection. However, blood cultures subsequently revealed the presence of <i>V. cholerae</i>, which was positively identified using both conventional and modern non-conventional technologies. The identity of the <i>V. cholerae</i> isolate was confirmed using Vitek MS (matrix-assisted laser desorption ionization-time of flight MS) and the FilmArray system, in addition to its initial identification using the Vitek 2 system. The septicaemia was successfully treated using a 14 day course of ciprofloxacin. <b>Conclusion.</b> The present case highlights the need to remain highly suspicious of non-O1/non-O139 <i>V. cholerae</i> infections in patients with known risk factors, as well as in healthy individuals with epidemiological exposure and compatible clinical symptoms. Special care should be taken to avoid false-positive results from confirmatory laboratory tests, as the organism can grow in fresh water, and the results should be verified using multiple methods.