A case of cholangitis with Vibrio fluvialis bacteremia possibly related to frequent consumption of supermarket sushi in a Japanese woman with a gallbladder-duodenal fistula.

Vibrio fluvialis is a halophilic, motile, flagellated, gram-negative bacterium commonly associated with acute gastroenteritis. However, extraintestinal infections are rare. We describe an unusual case of V. fluvialis cholangitis complicated by bacteremia in a 78-year-old woman with diabetes mellitus and a gallbladder-duodenal fistula. The patient presented with fever and altered mental status, with a history of frequent sushi consumption. Blood cultures yielded V. fluvialis, identified through matrix-assisted laser desorption/ionization time-of-flight mass spectrometry with the MALDI Biotyper (Bruker Daltonics Co., Ltd., Yokohama, Japan) and biochemical properties. The patient was successfully treated with 7 days of intravenous ceftriaxone. There was no recurrence of fever for 6 days from the completion of antimicrobial treatment to discharge. This case underscores the need for heightened awareness of V. fluvialis as a potential pathogen in patients with predisposing conditions and dietary habits involving raw seafood. Further research is warranted to elucidate the mechanisms underlying its extraintestinal manifestations.