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Vibrio fluvialis, an enteric, Gram negative bacterium commonly isolated from sewage/ sea water contaminated with human and animal’s faeces. Infections with this unusual organism can cause cholera like bloody diarrhoea and also wound infection. Vibrio fluvialis causing skin infection and sepsis is uncommon with very few cases reported worldwide. It is an emerging pathogen with distinct features as compares to the other species of Vibrio group of bacteria in terms of high virulence and adaptability in hostile environments. Here is a case report of skin and soft tissue infection by Vibrio fluvialis, in a patient suffering from severe pedal oedema due to nephrotic syndrome and right lower limb deep vein thrombosis .
Case Report: A young male, farmer, presented with ascites, pedal oedema, puffy face due to nephrotic syndrome.He developed skin and soft tissue infection resulted from skin atrophy and ulcer due to pedal oedema as well as right limb deep vein thrombosis . He had high grade fever, leucocytosis, anaemia, hypoproteinaemia, right leg cellulites and features of sepsis requiring wound debridement. Immunodeficiency and corticosteroids associated immunosuppression were absent in this patient. He was diagnosed with nephrotic syndrome due to minimal change disease.
Conclusion: Vibrio fluvialis infection can occur due to wound contaminated with sewage water leading to skin and soft tissue infection and life threatening sepsis.
Igbinosa EO, Okoh AI. Vibrio fluvialis: An unusual enteric pathogen of increasing public health concern. Int J Environ Res Public Health. 2010;7(10):3628- 3643.
Eline Boelee, Gertjan Geerling, Bas van der Zaan, Anouk Blauw, A. Dick Vethaak. Water and health: From environmental pressures to integrated responses. Acta Tropica. 2019;193:217-226.
Pandey PK, Kass PH, Soupir ML, Biswas S, Singh VP. Contamination of water resources by pathogenic bacteria. AMB Express. 2014;4:51.
Igbinosa EO, Obi LC, Okoh AI. Occurrence of potentially pathogenic vibrio in final effluents of a wastewater treatment facility in a rural community of the Eastern Cape Province of South Africa. Research in microbiology. 2009;160(8):531-7.
Schembri MA, Givskov M, Klemm P. An attractive surface: Gram-negative bacterial biofilms. Science's STKE. 2002;2002(132):re6.
Römling U. Innate immune mechanisms with a focus on small-molecule microbe-host cross talk. Journal of innate immunity. 2019;11(3):191-2.
Albertson NH, Nyström T, Kjelleberg S. Macromolecular synthesis during recovery of the marine Vibrio sp. S14 from starvation. Microbiology. 1990;136(11):2201-7.
Huq A, Colwell RR. A microbiological paradox: Viable but nonculturable bacteria with special reference to Vibrio cholerae. Journal of food protection. 1996;59(1):96-101.
Aim RA, Stroeher UH, Manning PA. Extracellular proteins of Vibrio cholerae: Nucleotide sequence of the structural gene (hlyA) for the haemolysin of the haemolytic El Tor strain 017 and characterization of the hlyA mutation in the non‐haemolytic classical strain 569B. Molecular microbiology. 1988;2(4):481-8.
Morris Jr JG, Black RE. Cholera and other vibrioses in the United States. New England Journal of Medicine. 1985;312(6):343-50.
Lakhani Sucheta J, Hatkar Sunil, Lakhani Som J. Prevalence and factors associated with wound colonisation by staphylococcus species at tertiary care hospital: A cross-sectional study. Journal of Clinical and Diagnostic Research. 2020;14(12):DC24-DC27.
Lakhani Som J, Khara R, Lakhani Sucheta J, Shah C, Lakhani JD. Clinical and microbiological profile of skin and soft tissue infections (SSTI) leading to sepsis. Ind J Clin Exp Dermatol. 2018;4(3):158-64.
Swartz MN. Clinical practice. Cellulitis. N Engl J Med. 2004;350(9):904-12.
Huang KC, Wen-Wei Hsu R. Vibrio fluvialis hemorrhagic cellulitis and cerebritis. Clinical Infectious Diseases. 2005;40(9):75-7.
Tsai YH, Cheng CC, Huang TJ, Hsu RW. Necrotizing fasciitis and primary sepsis caused by Vibrio fluvialis: A case report. Injury Extra. 2005;36(12):546-9.
Tsai YH, Hsu RW, Huang KC, Chen CH, Cheng CC, Peng KT, Huang TJ. Systemic vibrio infection presenting as necrotizing fasciitis and sepsis: a series of thirteen cases. JBJS. 2004;86(11):2497-2502.
Chen PJ, Tseng CC, Chan HT, Chao CM. Acute Otitis due to Vibrio fluvialis after Swimming. Case reports in emergency medicine; 2012.
Han JH, Lee JH, Choi YH, Park JH, Choi TJ, Kong IS. Purification, characterization and molecular cloning of Vibrio fluvialishemolysin. Biochimica et BiophysicaActa (BBA)-Proteins and Proteomics. 2002;1599(1-2):106-14.
Garay E, Arnau A, Amaro C. Incidence of vibrio cholerae and related vibrios in a coastal lagoon and seawater influenced by lake discharges along an annual cycle. Applied and Environmental Microbiology. 1985;50(2):426-30.
Chowdhury G, Pazhani GP, Nair GB, Ghosh A, Ramamurthy T. Transferable plasmid-mediated quinolone resistance in association with extended-spectrum β-lactamases and fluoroquinolone-acetylating aminoglycoside-6′-N-acetyltransferase in clinical isolates of Vibrio fluvialis. International journal of antimicrobial agents. 2011;38(2):169- 73.
Haq SM, Dayal HH. Chronic liver disease and consumption of raw oysters: A potentially lethal combination—a review of: Vibrio vulnificus: Septicemia. American Journal of Gastroenterology. 2005;100(5):1195-9.