The rare care of infection caused by Vibrio cholerae non-O1, non-O139 in clinical practice in Slovakia


Cholerae is both a human pathogen and a natural inhabitant of aquatic environments. Vibrio cholerae non-O1, non-O139 (NOVC) are increasingly frequently observed ubiquitous microorganisms occasionally responsible for intestinal and extra-intestinal infections. Most cases involve self-limiting gastroenteritis or ear and wound infections in immunocompetent patiens. We describe a case of NOVC severe gastroenteritis in 44 year old fe­male subject suffering from acute diarrhea, abdominal pain, fever and dehydratation. Strains V. cholerae non-O1, non-O139 have been isolated from rectal swab and confirmed infectious causality of the clinical symptoms. In published case of NOVC gastroenteritis antimicrobial therapy was recommended, the optimal treatment strate­gy was oral ciprofloxacin (500 mg every 12h) and appropriate oral fluid rehydration. There was initial improve­ment, but the watery diarrhoea recurred and had been lasting for a few weeks. The patient recovered fully after 2 months. This infection was defined as domestically acquired, patient was exposured to the contaminated water from water well. The analysis of the water by National reference centre for Vibrionaceae confirmed the source of infection. NOVC may occur also in water with low salinity such as alkaline lakes, artificial waterways and sew­ers. Although all Vibrio infections are nationally notifiable, many cases are likely not recognized because Vibri­os are not easily identified on routine enteric cultivation media.

Keywords: acute gastroenteritis, Vibrio cholerae non-O1, non-O139, clinical significance, first confirmed case in Slovakia, contaminated water

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