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Locally acquired severe non-O1 and non-O139 Vibrio cholerae infection associated with ingestion of imported seafood

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To the Editor: We report a case of severe Vibrio cholerae infection acquired in Sydney, likely due to ingestion of imported seafood.

An 83-year-old man with Parkinson disease presented with a 3-day history of vomiting, large-volume watery diarrhoea and acute renal impairment necessitating admission to the intensive care unit. Blood cultures grew curved gram-negative bacilli, and intravenous piperacillin–clavulanic acid was commenced. Subsequent microbiological testing of blood isolated V. cholerae, prompting testing and confirmation of V. cholerae in stool cultures. The strain was identified as non-O1 and non-O139 by serotyping, and toxin gene-negative by polymerase chain reaction testing.

The patient subsequently reported ingestion of imported seafood (a marinara mix containing mussels from Chile, prawns from Vietnam and squid from China), purchased from a local supermarket, although none of the suspected food was available for testing. He had no recent travel history or exposure to marine or brackish-water environments and no unwell contacts.

Antimicrobial therapy was changed to ciprofloxacin. The patient’s recovery was complicated by caecal pseudo-obstruction requiring endoscopic decompression. He was discharged after 2 weeks…