Clinical-laboratory-therapeutic decision analysis of non-O1/O139 Vibrio cholerae bloodstream infection in high-risk patients: A case report and literature review.

OBJECTIVE

To describe a case of bloodstream infection caused by non-O1/O139 Vibrio cholerae (NOVC) and to summarize the clinical characteristics, risk profiles, and diagnostic-therapeutic considerations of invasive NOVC infections through a literature review.

METHODS

The clinical presentation, laboratory findings, microbiological results, and treatment course of a patient with NOVC bloodstream infection were retrospectively analyzed. A literature search was conducted in PubMed, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP databases using the terms "non-O1/non-O139 Vibrio cholerae".Previously reported cases were descriptively reviewed.

RESULTS

The patient presented with acute fever and gastrointestinal symptoms. Blood cultures grew Vibrio cholerae, which was subsequently identified as a non-O1/O139 serogroup. The patient recovered following appropriate antimicrobial therapy. Twenty-eight cases were identified from the literature; together with the present case, 29 cases were included in the analysis. Invasive NOVC infections predominantly occurred in individuals with underlying diseases or compromised immune status, with bloodstream infection being the most common clinical manifestation. Notably, some patients lacked typical diarrheal symptoms. Most isolates were susceptible to third- or fourth-generation cephalosporins, fluoroquinolones, and tetracyclines, although sporadic antimicrobial resistance was reported.

CONCLUSION

Although non-O1/O139 Vibrio cholerae bloodstream infection is uncommon, it may progress rapidly and is easily overlooked in high-risk patients. Enhanced clinical vigilance combined with timely laboratory identification is essential for early diagnosis and appropriate therapeutic decision-making.