Noncholera Vibrio infection

• Pathogen

  • Vibrio parahaemolyticus : non-lactose fermenter, gram-negative bacilli

  • Vibrio vulnificus: lactose fermenter, gram-negative bacilli

• Transmission

  • Foodborne (raw or undercooked shellfish)

  • Wounds infected by contaminated sea water

• Incubation period: 12–52 hours

• Inflammatory diarrhea

• Low-grade fever, vomiting, abdominal pain

• Cellulitis, bullous skin lesions

• Supportive therapy for gastroenteritis: e.g., bland diet, oral rehydration therapy

• Surgical debridement: may be needed in patients with severe wound infections

• Antibiotic therapy

  • Indications

    • Severe gastroenteritis due to V. parahaemolyticus

    • Gastroenteritis due to V. vulnificus

    • Wound infections due to Vibrio species

  • Suggested regimen: give for 7–14 days

    • Doxycycline

    • OR fluoroquinolone: e.g., ciprofloxacin

    • For patients with V. vulnificus and/or wound infections, add a third-generation cephalosporin: e.g., ceftazidime.

Infections caused by Vibrio species are often self-limiting and may only require supportive care.

• Complications of noncholera Vibrio infection are common in patients with high levels of free iron (e.g., liver disease, hemochromatosis) or immunocompromised state.

• Septic shock and necrotizing fasciitis associated with Vibrio vulnificus infection (rare)