Non-cholera Vibrio infections

Non-cholera Vibrio infections are infections caused by Vibrio species other than V cholerae.

Vibrio vulnificus is the most virulent and can rapidly produce fatal septic shock in immunocompromised patients or those with underlying liver disease.

The diagnosis is based on blood, wound, and/or stool cultures.

Treatment consists of intravenous antibiotic therapy with two agents for those with sepsis or severe systemic infection. Patients with necrotising skin/soft-tissue infection also require early aggressive debridement of the infected tissue. Localised skin/soft-tissue wound infections are managed with oral antibiotics and close observation.

Gastroenteritis syndromes are treated with rehydration. Oral antibiotics are indicated if diarrhoea persists >5 days.

Prognosis varies with the clinical presentation of the infection and whether there is any underlying comorbidity.

Vibrio infections are most often associated with consumption of raw or undercooked shellfish, or traumatic exposure to sea or brackish water. They are characterised by diarrhoea and vomiting, sepsis, and/or skin/soft-tissue infections. Ten non-cholera Vibrio species are associated with human disease. V parahaemolyticus, V alginolyticus, and V vulnificus are the most common organisms causing non-cholera Vibrio infections.