Acute Renal Failure Secondary to Vibrio cholera Gastroenteritis in a United States Citizen, Corrected With Renal Replacement Therapy.

Abstract

Cholera is an acute gastroenteritis that can lead to fatal dehydration and metabolic derangements. Cases of cholera in the United States are typically associated with international travel. Patients who are persistently dehydrated despite aggressive rehydration and antibiotic therapy may require hemodialysis until symptom resolution and stabilization of renal function. We present a case of a 47-year-old male who recently returned from a trip to Haiti and presented with intractable abdominal pain, nausea, vomiting, and watery diarrhea. He was found to be in acute renal failure with a high anion gap metabolic acidosis of an unclear etiology. Abdominal imaging was consistent with enterocolitis, and his stool culture grew Vibrio cholerae. In addition to aggressive fluid resuscitation, he underwent two intermittent hemodialysis sessions and received sodium bicarbonate and antibiotic therapy. Renal function normalized by hospital day 6. This is a novel case of severe renal failure and high anion gap metabolic acidosis in a US patient with cholera; our review of the literature did not find any case reports regarding cholera in the past decade involving a US citizen.