V. alginolyticus is generally considered to be a pathogen of extraintestinal sites and has been implicated in infections of soft tissue, wound, eye, and ear. In a few cases it has also been implicated as a causative agent of gastroenteritis.
The role of V. alginolyticus in gastroenteritis is not well defined. A few reports have described the isolation of the organisms from clinical samples of patients with gastroenteritis. It was isolated from "rice water" diarrheal stool of a female with acute enterocolitis and also from the trout roe that she had eaten (44). It has been isolated from an 8-month-old male child and an 18-year-old female suffering from acute gastroenteritis with symptoms such as watery diarrhea and vomiting that lasted 2 days (45). V. alginolyticus was the only organism isolated from the child; V. alginolyticus, Escherichia coli, and Pseudomonas spp. were isolated from the rectal swab of the 18-year-old female. Chapman (46) described the isolation of the organism from two cases of diarrhea in travelers returning from India and Nepal. However, in addition to this organism, both patients had either Campylobacter jejuni or Shigella sonnei, which are well-known enteric pathogens. V. alginolyticus was isolated from stools of an immunocompetent 75-year-old man who developed diarrhea during his stay in the hospital (47). Absence of viruses and parasites suggested that V. alginolyticus might have been the most probable cause of infection. The diarrhea was greenish in appearance and contained mucus and lasted 2 days. Stool culture performed 6 days after the diarrheal episode was negative for the pathogen. It is interesting to note that the patient did not have a history of recent travel, exposure to seawater, or consumption of raw seafood. Caccamese and Rastegar (48) reported the case of an immunocompromised 38-year-old man who had a 3-month history of diarrhea. He had about five episodes of watery nonbloody diarrhea per day and denied having made any recent trips to the sea or eating raw seafood. V. alginolyticus was the only organism identified in the stool culture. Of all the cases of gastroenteritis described here, V. alginolyticus was isolated as the only organism in four of them (44,45,47,48).
V. algininolyticus has been implicated as a causative agent of infection in various extraintestinal sites. The most common presentations of these infections are cellulitis, otitis media, otitis externa, and conjunctivitis, and bacteremia in immunocompromised hosts. Pien et al. (49) reviewed eight cases in which the pathogen was isolated from infections in the toe, shin, foot, scalp, and ear. It was the only bacterium isolated from four of the infections and was considered to be the most probable causative agent. It has been isolated from wound infections of patients who have had recent exposure to seawater (50-59). The patients had conditions such as wound infections in the leg, cellulitis of the leg and leg ulcer, ulcerated lesions, necrotizing fasciitis, superficial septicemic lesions, and open head injury. In a study in Western Australia, it was isolated from 20 of the 36 samples of infected superficial wounds that had come in contact with seawater (60). The pathogen has been reported to cause conjunctivitis (52,61,62) and infections of the ear (49,63,64). Its ability to cause bacteremia has been demonstrated by its isolation from blood of a burn patient (53), of a man diagnosed as having acute sphenoiditis (65), and of a patient who had osteogenic sarcoma (66). In one instance it was associated with peritonitis in a 20-year-old man who had end-stage renal failure and had changed his peritoneal dialysis fluid on the beach where he had been scuba diving (67). His symptoms included severe abdominal pain, fever, and signs of peritonism. The pathogen was also recovered from the dialysis fluid.
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