title: Non-O1/non-O139Vibrio choleraesepticaemia in a Saudi man: a case report.
abstract: Background.The non-O1/non-O139 serogroups ofVibrio choleraeoccur 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.Case presentation.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 indicateV. choleraeinfection. However, blood cultures subsequently revealed the presence ofV. cholerae, which was positively identified using both conventional and modern non-conventional technologies. The identity of theV. choleraeisolate 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.Conclusion.The present case highlights the need to remain highly suspicious of non-O1/non-O139V. choleraeinfections 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.
authors.affiliation: Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Infection Control and Environmental Health, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
authors.forename: Reham
authors.initials: R
authors.lastname: Kaki
authors.affiliation: Clinical and Molecular Microbiology Laboratory, King Abdulaziz University Hospital, Jeddah, Saudi Arabia; Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
authors.forename: Dalia
authors.initials: D
authors.lastname: El-Hossary
authors.affiliation: Clinical and Molecular Microbiology Laboratory, King Abdulaziz University Hospital, Jeddah, Saudi Arabia; Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Asif
authors.initials: A
authors.lastname: Jiman-Fatani
authors.affiliation: Department of Medicine, Faculty of Medicine, King Abdulaziz University , Jeddah , Saudi Arabia.
authors.forename: Rahaf
authors.initials: R
authors.lastname: Al-Ghamdi
keywords: Non-O1/Non-O139 Vibrio cholerae; septicaemia