[A case of cardiogenic shock caused by Vibrio parahaemolyticus]

A case of a 53 year old healthy female complaining of diarrhea and abdominal pain after taking raw fish is presented. She immediately went into shock and unconsciousness. Central venous pressure was 8 cmH2O and her ECG showed a first-degree AV block and ST-T changes in almost all leads. After mechanical ventilation and administration of dopamine, dobutamine, cefotiam, ciprofloxacin, she became alert and recovered from her critical condition. V. parahaemolyticus which produces thermostable direct hemolysin (TDH) was cultured from the feces on admission. Kanagawa phenomenon was positive. Arterial blood culture was negative and the titer of serum endotoxin was low. The diagnosis of cardiogenic shock due to exotoxin produced by V. parahaemolyticus was made. Serological examination by ELISA showed elevation of IgG class antibody against TDH and TRH (TDH related hemolysin). And antibody against TDH was normalized after 180 days. By review of literature, there are some case reports of cardiogenic shock complicated with V. parahaemolyticus infection, but few showed elevation of antibody against TDH and TRH in the serum of the survived patient.