Cholera on the Louisiana Gulf Coast: historical notes and case report

A 67-year old woman was brought by ambulance to the hospital because of syncope and collapse. Forty-eight hours prior to the admission she ate some crabs with her husband. The morning of admission she awakened with massive, watery diarrhea followed by vomiting and shock. She was admitted to the intensive care unit with hypotension and bradycardia. She was resuscitated after a large volume of fluid was administered. Approximately 22 liters of fluids were administered in 24 hours. Stool cultures grew out Vibrio cholerae 01 biotype El Tor, serotype Inaba. She was treated with intravenous doxycycline. Her recovery was uneventful. The patient's husband had mild diarrhea, and Vibrio cholerae 01 biotype El Tor, serotype Inaba was cultured from his stool. Vibrio cholerae is endemic on the Louisiana Gulf Coast. The first cholera epidemic occurred in 1832. After a hiatus of about 100 years, cholera reappeared in Louisiana in 1978.