Vibrio Cholerae

Vibrio Cholerae

Updated: 02/19/2024

© Jun Wang, MD, PhD

 

General features

  • G-negative, facultative anaerobe and highly motile comma-shaped bacteria
  • Lives in warm brackish water
  • Copepods or shellfish in contaminated water
  • Higher risk after natural disaster
  • Human carriage may persist after untreated infection

Key clinical features

Pathogenesis

  • Attachment to intestinal mucosa
    • Motility
    • Mucinase
    • Toxin co-regulated pili (TCP)
  • Cholera enterotoxin (choleragen): similar to E. coli LT
    • Activation of adenylate cyclase
    • Increased cAMP
    • Efflux of Cl– and H2O

Diagnosis

  • Presumptive diagnosis in patients with severe diarrhea
  • Confirmation
    • Isolation of v. cholerae from stool culture
    • Grow on thiosulfate citrate bile sucrose agar or taurocholate tellurite gelatin agar
    • Antigen detection
    • Molecular testing
    • Darkfield microscopy

Management

  • Adequate IV Fluid and electrolyte replacement
  • Doxycycline or ciprofloxacin
  • Resistance to tetracycline and TMS reported

 

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