Vibrio cholera Bacteremia Secondary to Ascending Cholangitis in a Patient Not on Chemotherapy or Immunosuppressants

Abstract

Non-O1, non-O139 Vibrio cholera (NOVC) are considered non-pathogenic organisms, but in some cases, it is known to be responsible for self-limiting intestinal and extra-intestinal infections in immunocompetent individuals. On the other hand, NOVC bacteremia affects mainly immunocompromised patients with significantly high mortality rates. We report a case of an 80-year-old female with a 20-year history of multiple abdominal surgeries. She is also known to have ischemic heart disease and atrial fibrillation. The patient presented with abdominal pain and signs of septic shock. Her abdominal imaging showed features of ascending cholangitis, while her blood culture grew V. cholera. She was discharged after completing the course of antibiotics but then came back with a similar presentation. The repeated blood culture showed Clostridium perfringens, while other cultures were negative. The patient's condition worsened due to sepsis, and she passed away. NOVC bacteremia is a fatal disease even in hosts who are not receiving immunosuppressants or chemotherapy. It may present without a history of diarrhea or seafood ingestion. In such situations, abdominal imaging is necessary to identify the presence of intra-abdominal infections.