Vibrio parahaemolyticus infection
Inoculation with this organism occurs after ingestion of infected seafood or exposure to coastal waters. Ingestion of contaminated raw or undercooked shellfish is the most common route of exposure, with raw oysters causing the bulk of gastrointestinal infections.
The most common presentation of V. parahaemolyticus infection is gastroenteritis, which starts 24-72 hours post-ingestion. Diarrhea is initially explosive in nature, watery, occasionally mucoid or bloody, and can be associated with abdominal pain and severe cramping. Diarrhea may be associated with nausea or vomiting. Fever, chills, and headache may be present in a minority of cases. Normally, the disease is self-limiting; however, immunocompromised hosts, children, and elderly patients may require medical care and parenteral rehydration.
A less common presentation is that of a wound infection with or without associated bacteremia or sepsis. The wound will be associated with a history of exposure to salt water, especially in warm climates. These patients should be treated with appropriate local debridement, supportive care, and antibiotics.
A05.3 – Foodborne Vibrio parahaemolyticus intoxication
406626001 – Infection due to Vibrio parahaemolyticus
Differential Diagnosis & Pitfalls
- Enterotoxigenic Escherichia coli – Most common cause of travelers' diarrhea.
- Salmonella – May be associated with undercooked poultry.
- Shigella – May have bloody diarrhea.
- Viral gastroenteritis (eg, norovirus, rotavirus) – Tends to be associated with vomiting as well as diarrhea.
- Staphylococcus aureus enterotoxin – Often associated with vomiting as well as diarrhea, and has a rapid onset after consumption of contaminated food.
- Clostridium perfringens – Specifically associated with reheated cooked rice.
- Clostridioides difficile – Usually presents after known antibiotic usage and is associated with severe, watery diarrhea and leukocytosis.
- Any organism found in water should be considered.
- Vibrio vulnificus can cause a severe skin and soft tissue infection that can quickly lead to a sepsis syndrome. It is often characterized by cellulitis that rapidly forms hemorrhagic bullae.