RESUMEN
Vibrio cholerae serogroups O1 or O139 are the aetiological agents of cholera. The pathogenicity of non-O1, non-O139 V. cholerae is less well known. These worldwide bacteria are responsible for gastrointestinal infections or, more rarely, bacteraemia in patients with an underlying disease, leading to life-threatening complications. We report a case of non-O1, non-O139 V. cholerae bacteraemia due to a haemolytic strain in a cirrhotic patient. Early antibiotherapy allowed a good outcome. The aim of this case report is to underline the virulence of non-choleragenic Vibrio strains, possibly linked to haemolysin production, and the potential danger of consuming undercooked seafood or exposing wounds to sea water in cirrhotic patients.
Asunto(s)
Bacteriemia/diagnóstico , Cirrosis Hepática/complicaciones , Vibriosis/complicaciones , Vibriosis/diagnóstico , Vibrio cholerae no O1/aislamiento & purificación , Antibacterianos/uso terapéutico , Bacteriemia/tratamiento farmacológico , Bacteriemia/microbiología , Proteínas Bacterianas/metabolismo , Enfermedades Transmitidas por los Alimentos/microbiología , Proteínas Hemolisinas/metabolismo , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Vibriosis/tratamiento farmacológico , Vibriosis/microbiología , Vibrio cholerae no O1/clasificación , Factores de Virulencia/metabolismoRESUMEN
Liver failure as a result of neoplasia is a rare event before the terminal stage of the illness. We report a 66-year-old man who presented with clinical features of acute liver failure as the initial manifestation of a small-cell lung carcinoma. Liver was enlarged without ascitis. Abdominal CT-scan revealed a massive hepatomegaly with multiple low-density wedge-shaped lesions. The patient developed stage 3 hepatic encephalopathy and died on day 4. The diagnosis was obtained with post-mortem study. A Medline search of acute liver failure due to small-cell carcinoma identified only 17 cases already published, with a universally poor prognosis.
