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For further information, see CMDT Part 33-21: Infections Caused by Other Vibrio Species

Key Features

  • Vibrios other than Vibrio cholerae that cause human disease are V parahaemolyticus, V vulnificus, and V alginolyticus

  • Infection is acquired by exposure to organisms in contaminated, raw, or undercooked crustaceans or shellfish and warm (> 20°C [82.4°F]) ocean waters and estuaries

  • Oysters are implicated in up to 90% of food-related cases

Clinical Findings

  • V cholerae

    • Causes voluminous diarrhea, rapid development of marked dehydration, and death if untreated

    • Rehydration and antimicrobial therapy are life-saving

  • V parahaemolyticus

    • Causes acute watery diarrhea with crampy abdominal pain and fever, typically within 24 hours after ingestion of contaminated shellfish

    • Disease is self-limited

    • Antimicrobial therapy usually not necessary

  • V vulnificus and V alginolyticus

    • Neither cause diarrhea

    • They do, however, cause cellulitis, wound infections, and primary bacteremia after ingestion of contaminated shellfish or exposure to sea water

    • Cellulitis with or without sepsis may occur with

      • Bulla formation

      • Necrosis

      • Extensive soft tissue destruction, at times requiring debridement and amputation

    • Infection can progress rapidly and be severe in immunocompromised individuals, especially those with cirrhosis, with death rates as high as 50%


  • Culture


  • Doxycycline, 100 mg orally twice daily, plus ceftriaxone, 2 g intravenously daily, for 7–10 days, is treatment of choice for suspected or documented primary bacteremia or cellulitis caused by Vibrio species

  • V vulnificus may also be susceptible to

    • Penicillin

    • Ampicillin

    • Cephalosporins

    • Chloramphenicol

    • Aminoglycosides

    • Fluoroquinolones

  • V parahaemolyticus and V alginolyticus

    • Resistant to penicillin and ampicillin

    • Otherwise, susceptibilities are similar to V vulnificus

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