OVERVIEW
Bacteria of the Vibrio family include Vibrio spp. and Vibrio-like species. The population is generally susceptible to Vibrio spp. and the disease is more prevalent in young adults. Immunodeficient people, alcoholism, cholecystitis patients, etc. are prone to Vibrio septicemia. The disease can occur in all seasons, with summer being the most common. Clinical manifestations vary, with two main aspects: one is diarrhea and other gastroenteritis manifestations; the other is extraintestinal infections, which commonly include mouth, ear and wound infections, as well as sepsis. These extra-intestinal infections can be seen in infections such as Vibrio anisopliae and Vibrio traumaticus.
Etiology
1. Vibrio riveris
Vibrio riveris is a halophilic bacterium Gram-stain negative, apically monoflagellated and motile. Some studies believe that this bacterium can produce enterotoxin and cytotoxin. The bacteria are sensitive to most broad-spectrum antibacterial drugs, but resistant to penicillin and cephalosporin antibiotics.
2. Vibrio anisopliae
Non-halophilic. Gram-negative, single flagellum, with power. Some strains can produce enterotoxin this bacteria are sensitive to commonly used antibacterial drugs. Close relationship with atypical Vibrio cholerae, its morphology, DNA sequence and nature and Vibrio cholerae is very similar, but the biochemical reaction is atypical, 1981 from diarrhea patients detected in the feces of the bacterium, so by foreign scholars named “Vibrio anamorphic”.
3. Vibrio Hollis
Salt-loving bacteria. There is a weak hemolytic ring on the culture medium. The bacterium exists in seawater, and most patients have a history of eating seafood before the disease. The onset of the disease is common in young adults. Diarrhea symptoms are severe, watery stools, mucus stools, and a few bloody stools. Mildly self-cured, severe cases should be rehydrated to correct water loss and electrolyte disorders.
4. Vibrio felis
Morphology and biochemical reactions are basically the same as Vibrio riveris originally classified as Vibrio riveris, DNA correlation experiments have confirmed that it is an independent species, this bacteria exists in the ocean.
5. Vibrio alginolyticus
Vibrio parahaemolyticus is the second biotype, and its pathogenicity is rarely reported.
6. Vibrio vulnificus
Vibrio vulnificus can cause wound infection and sepsis.
7. Vibrio eel
Mainly causes disease in animals.
8.Vibrio mechnikovii
It is also an animal pathogen, causing cholera-like disease in chickens. It has been reported to cause human diseases.
9. Vibrio maritimus
This bacterium has tissue invasive power and produces cytolytic toxin, which is the pathogen of human and fish diseases.
Symptoms
The incubation period is from a few hours to 3 days. The clinical manifestations of Vibrio infections vary, and there are two main aspects: one is diarrhea and other gastroenteritis manifestations; the other is extra-intestinal infections, which are commonly found in the mouth, ear and wound infections, as well as sepsis. These extra-intestinal infections can be seen in the infections of Vibrio anisopliae and Vibrio atraumaticus, and so on.
1. Vibrio traumaticus infection
The two most common clinical manifestations are wound infections and primary sepsis.
2. Vibrio riveris infection
The manifestation of acute gastroenteritis, abdominal pain, vomiting diarrhea, watery stools, large amount, often accompanied by moderate to severe dehydration, some patients have fever. A few patients have bloody stools, mucous blood stools and peripheral blood leukocytosis 2/3 cases have leukocytes and red blood cells in the feces. The duration of the disease is 16 to 18 hours.
3. Vibrio felis infection
Incubation period 5～20 hours, mainly manifested as acute gastroenteritis with abdominal pain, diarrhea, nausea and vomiting.
4. Vibrio anisopliae infection
There are two clinical types. One is gastroenteritis type, most of the patients have diarrhea, watery stools or bloody mucus stools, some of which are bloody. Most of them are accompanied by nausea, vomiting and abdominal pain, and some of them have fever and headache. The average duration of the disease is 6 days. Another focal infection type manifested as otitis media, traumatic focal infection, etc., patients have obvious history of seawater contact.
5. Vibrio hollis infection
Patients have diarrhea, some have vomiting and fever peripheral blood leukocytosis. All had a history of eating oysters and other seafood.
6. Vibrio Metchnikoff infection
It can cause diarrhea, peritonitis and sepsis.
7. Vibrio maritimus infection
Generally the condition is mild with diarrhea, yellow watery stools, large amount, a few have mucus or mucus-pus-blood stools. Some cases have paroxysmal periumbilical pain and vomiting. A few have acute and severe symptoms. In some patients, a few red blood cells and white blood cells can be seen in stool microscopy.
8. Vibrio alginolyticus infection
Diarrhea is the main manifestation of mild symptoms, dehydration is rare.
Examination
1. Vibrio riveris infection
A few patients have bloody stools, mucous blood stools and peripheral blood leukocytosis. 2/3 cases have leukocytes and erythrocytes in the feces. Patients with Vibrio hollis infection have diarrhea, some have vomiting and fever, and peripheral blood leukocytosis.
2. Vibrio maritimus infection
Few red blood cells and leukocytes can be seen in stool microscopy.
Diagnosis
Acute gastroenteritis with a history of eating seafood, septicemia and skin trauma after exposure to seawater should be suspected of this type of disease, the diagnosis depends on the bacterial isolation culture and biochemical and serological identification.
Differential diagnosis
Clinically, it should be differentiated from cholera and non-group 01 Vibrio cholerae enteritis.
Complications
Acute renal failure and pulmonary edema may occur.
Treatment
The general diarrhea of Vibrio infection requires only symptomatic treatment. For invasive diarrhea and accompanying traumatic infections or sepsis should take appropriate antibacterial therapy, the bacteria are more sensitive to fluoroquinolone antibacterial drugs, third-generation cephalosporins and amikacin.