Vibrio fluvialis cholangitis with bacteremia and refractory septic shock: a case report and review of the literature.

Abstract

Vibrio fluvialis is an emerging pathogen primarily associated with gastroenteritis, though an increasing number of extraintestinal infections have been reported. We present the first documented case in Europe of V. fluvialis cholangitis with liver abscess and bacteremia. An 85-year-old man with diabetes mellitus and chronic steroid use was admitted with severe epigastric pain but no fever or gastrointestinal symptoms. Initial laboratory tests were unremarkable, yet imaging revealed a hepatic abscess. Despite early antibiotic therapy, the patient rapidly developed refractory septic shock and died within 12 h. Blood cultures confirmed V. fluvialis. This case highlights the potential for severe V. fluvialis infections even in the absence of known seafood or seawater exposure. Given the global rise in raw seafood consumption, physicians should consider V. fluvialis as a potential pathogen in diabetic or immunocompromised patients presenting with hepatobiliary infections and sepsis.