Overview
Infections caused by non-Vibrio cholerae, which are biochemically and serologically distinct from Vibrio cholerae, can result in wound infections, enterotoxicosis, or diarrhea depending on the causative species. It should be differentiated from cholera and bacillary dysentery. Avoidance of contaminated or unfresh food, and avoidance of handling unburned seafood and contact with seawater in patients at risk for skin wounds can play a positive role in prevention.
Etiology
Foodborne disease, mostly caused by ingestion of food containing non-cholera vibrios such as Vibrio parahaemolyticus, Vibrio anisopliae, Vibrio alginolyticus, Vibrio cholerae, Vibrio traumaticus and the so-called non-agglutinating vibrios. Vibrio parahaemolyticus, among others.
Symptoms
After an incubation period of 15 to 24 hours, the disease begins to flare up acutely with cramping abdominal pain, watery diarrhea stools, which may be bloody and contain polymorphonuclear leukocytes, a severe acute illness, malaise, and sometimes a low-grade fever, and the symptoms subside on their own after 24 to 48 hours. Vibrio noncoagulans can cause a cholera-like illness, and can be isolated from wounds and the bloodstream, and wounds infected by warm seawater can evolve to cellulitis Wounds infected by warm seawater may evolve into cellulitis, and in some cases may rapidly deteriorate into necrotizing fasciitis with typical hemorrhagic and maculopapular lesions. Vibrio traumaticus can pass through the intestinal mucosa when ingested by compromised hosts (often liver disease or immunodeficiencies) without causing enterocolitis, but it can result in septicemia, which is associated with a high mortality rate.
Examination
Feces are cultured in thiosulfate-citrate-bile-sucrose medium to isolate pathogenic Vibrio, and contaminated seafood is cultured.
Diagnosis
The diagnosis can be confirmed on the basis of history, clinical signs and symptoms and laboratory tests.
Differential diagnosis
It should be differentiated from cholera and bacillary dysentery.
Complications
Water and electrolyte metabolic disorders and shock.
Treatment
Non-Vibrio cholerae infections can be treated with ciprofloxacin single dose orally.
Close attention should be paid to replenish blood volume and lost electrolytes during diarrhea, and surgical debridement should be performed in addition to antibiotics in patients with necrotizing fasciitis.
Prevention
Avoid contaminated or unfresh food, and patients at risk for skin wounds should avoid handling unburned seafood and contact with seawater.