Bacteremic cellulitis caused by non-O1 Vibrio cholerae: report of a case

A 44-year-old man presented with a fever of a two-day duration and bullous cellulitis of the lower extremities. He had prepared and eaten saltwater fish three days prior to admission. Both blood and bullous fluid cultures showed non-O1 Vibrio cholerae. The bacteremic cellulitis resolved gradually after four weeks of intravenous cefamandole therapy and surgical debridement. Non-O1 V. cholerae bacteremia is rarely reported in the English-language literature and is almost always associated with saltwater exposure, ingestion of seafood, or immunocompromised hosts, particularly those with hematologic malignancies, or liver cirrhosis. Our patient was an alcoholic, but there was no evidence of liver cirrhosis from the physical examination or abdominal sonogram. He is the fourth reported case of non-O1 V. cholerae bacteremic cellulitis in the English-language literature and the first proven case in Taiwan.