A Rare Case of Non-O1, Non-O139 Vibrio Cholera Bacteraemia Causing Hepatic Encephalopathy in Cirrhotic Patient

Abstract

Background: Vibrio cholera serogroups O1 or O139 are the aetiological agents of cholera. The pathogenicity of non-O1, non-O139 Vibrio cholera (NOVC) is less well known. NOVC bacteria are responsible for gastrointestinal infections or, more rarely, bacteraemia in patients with an underlying disease, leading to life-threatening complications. Case Summary: We report a case of 63 years old male who has chronic liver disease with portal hypertension and presented to us with grade III hepatic encephalopathy. He was started on rifaximin, lactulose solution and intravenous cephalosporin after sending his blood cultures. Later his blood culture grew non-O1, non-O139 Vibrio cholera strain. He was continued on cephalosporin as per sensitivity pattern and early antibiotic therapy allowed good outcome in our case. On retrospective history, contaminated water was the source of infection. Non-O1, non-O139 Vibrio cholera bacteraemia is rare but potentially fatal infection and cirrhotic patients are at particular risk. Conclusion: 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 contaminated water, undercooked seafood or exposing wounds to sea water in cirrhotic patients. The authors have none to declare.