Vibrio
20%
1 / 5
A 75-year-old woman with PMH hypertension, diabetes, hyperlipidemia, and GERD presents with four days of abdominal pain, fevers, chills, vomiting, and diarrhea after eating raw crab 48 hours prior. Blood cultures grow out gram negative rods. What is the diagnosis?
Explanation : Answer: Vibrio cholerae non-O1/non-0139 strain. Only a subset of V. cholerae strains carry the requisite genes to cause cholera. Non-01/non-0139 strains have been associated with gastroenteritis and, rarely, septicemia in immunocompromised patients. The morphology of the Vibrio (commas, gull wings) on gram stain may be confused with Campylobacter which can present in similar fashion.
40%
2 / 5
Non-01/non 0139 V. cholerae strains that cause septicemia/bacteremia are unencapsulated.
Explanation : Answer: False. Nearly all non-O1/non-0139 V. cholerae strains isolated from the blood are heavily encapsulated, similar to that reported in Vibrio vulnificus. Johnson JA, Joseph A, et al. Frequency of encapsulated versus unencapsulated strains of non-01 Vibrio cholerae isolated from patients with septicemia or diarrhea or from environmental strains. American Society for Microbiology Annual Meeting, New Orleans, Louisiana, May 26-30, 1992.
60%
3 / 5
Clinical manifestations of non-01/non-139 V. Cholerae include:
Explanation :
80%
4 / 5
Which of the following is FALSE regarding Vibrio vulnificus?
Explanation : Answer: B. Vibrio vulnificus thrives in warmer temperatures in the summer months when water temperatures are highest.
Wright AC, Hill RT, et al. Distribution of Vibrio vulnificus in the Chesapeake Bay. Appl Environ Microbiol 1996; 717-724.
100%
5 / 5
Which of the following has been associated with the virulence of V. vulnificus?
Explanation : Answer: D. All of the above. Vibrio vulnificus produces a capsular polysaccharide that protects it against phagocytosis and opsonization. It also produces a variety of extracellular toxins, including metallo protease VvpE, the cytokinin/hemolysin VvhA, and multifunctional auto-processing repeat-in-toxins (MARTX) toxin. Vibrio vulnificus\'s growth is dependent on iron availability, which may account for the enhanced vulnerability of patients with hemochromatosis for severe disease/septicemia. Morris JG. Vibrio Vulnificus infection. UpToDate.
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