Fatal bacteremia due to immotile Vibrio cholerae serogroup O21 in Vientiane, Laos – a case report

Rattanaphone Phetsouvanh¹ , Masami Nakatsu² , Eiji Arakawa³ , Viengmone Davong¹ , Manivanh Vongsouvath¹ , Olay Lattana¹ , Catrin E Moore¹^,4 , Satoshi Nakamura² and Paul N Newton¹^,4

¹Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PD

²Department of Appropriate Technology Development and Transfer, Research Institute, International Medical Centre of Japan, Tokyo, Japan

³Department of Bacteriology, National Institute of Infectious Diseases, Tokyo, Japan

⁴Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, UK

author email corresponding author email

Annals of Clinical Microbiology and Antimicrobials 2008, 7:10doi:10.1186/1476-0711-7-10


Published:	25 April 2008

Abstract

Background

Human infections with non-O1, non-O139 V. cholerae have been described from Laos. Elsewhere, non cholera-toxin producing, non-O1, non-O139 V. cholerae have been described from blood cultures and ascitic fluid, although they are exceedingly rare isolates.

Case presentation

We describe a farmer who died with Vibrio cholerae O21 bacteremia and peritonitis in Vientiane, Laos, after eating partially cooked apple snails (Pomacea canaliculata) and mussels (Ligumia species). The cultured V. cholerae were non-motile. PCR detected ompW and toxR gene regions but not the ctxA, ompU, omp K and TCP gene regions. Although the organisms lacked flagellae on scanning electron microscopy, they possessed the Vibrio flagellin flaA gene.

Conclusion

Severe bacteremic non-O1, non-O139 V. cholerae is reported from Laos. The organisms were unusual in being non-motile. They possessed the Vibrio flagellin flaA gene. Further research to determine the reasons for the non-motility and virulence is required.