Vibrio parahaemolyticus bacteremia in decompensated cirrhosis complicated by spontaneous bacterial peritonitis following occupational seafood exposure: A case report.
- 1College of Medicine, University of Florida, Gainesville, FL, USA.
- 2Department of Infectious Diseases, College of Medicine, University of Florida, Gainesville, FL, USA.
Abstract
Introduction
Vibrio parahaemolyticus is a halophilic marine Gram-negative bacterium most commonly associated with seafood-related gastroenteritis. Invasive infection is uncommon but may be severe in patients with chronic liver disease, and non-ingestive occupational exposure is an underrecognized route of infection.Presentation of case
A man in his early 60 s with alcohol-associated decompensated cirrhosis and recurrent ascites presented with abdominal pain and sepsis. Ascitic fluid contained > 10,000 polymorphonuclear cells/µL, meeting diagnostic criteria for spontaneous bacterial peritonitis (SBP), although ascitic cultures remained negative. Four of four blood-culture bottles grew V. parahaemolyticus. He denied raw seafood ingestion but had worked as a fish cleaner for two years with frequent minor skin lacerations. Bacteremia cleared and ascitic neutrophilia improved with cephalosporin and doxycycline therapy, but his course was complicated by progressive multiorgan failure and subsequent Candida glabrata fungemia. He died after transition to comfort-focused care.Discussion
The concurrent bacteremia and marked culture-negative neutrocytic ascites raise the possibility of hematogenous peritoneal involvement, but organism-specific SBP could not be microbiologically confirmed. Occupational inoculation through disrupted skin was considered a plausible portal of entry.Conclusion
In patients with cirrhosis and sepsis, clinicians should assess occupational and environmental marine exposures even when seafood ingestion is absent and should avoid attributing culture-negative SBP to a bloodstream isolate without direct peritoneal microbiologic confirmation.
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BibTeX
@article{truong2026vibrio,
title = {{Vibrio parahaemolyticus bacteremia in decompensated cirrhosis complicated by spontaneous bacterial peritonitis following occupational seafood exposure: A case report.}},
author = {Thi Vy Ngoc Truong and Hac-Tu T Chung and Sai Pavan Kumar Chintalapati and Pooja Gurram},
journal = {IDCases},
year = {2026},
month = oct,
doi = {10.1016/j.idcr.2026.e02802},
url = {https://europepmc.org/article/MED/42960176},
note = {CC BY},
}
RIS
TY - JOUR
TI - Vibrio parahaemolyticus bacteremia in decompensated cirrhosis complicated by spontaneous bacterial peritonitis following occupational seafood exposure: A case report.
AU - Thi Vy Ngoc Truong
AU - Hac-Tu T Chung
AU - Sai Pavan Kumar Chintalapati
AU - Pooja Gurram
PY - 2026
DA - 2026/10/14
JO - IDCases
DO - 10.1016/j.idcr.2026.e02802
UR - https://europepmc.org/article/MED/42960176
AB - Introduction Vibrio parahaemolyticus is a halophilic marine Gram-negative bacterium most commonly associated with seafood-related gastroenteritis. Invasive infection is uncommon but may be severe in patients with chronic liver disease, and non-ingestive occupational exposure is an underrecognized route of infection.Presentation of case A man in his early 60 s with alcohol-associated decompensated cirrhosis and recurrent ascites presented with abdominal pain and sepsis. Ascitic fluid contained > 10,000 polymorphonuclear cells/µL, meeting diagnostic criteria for spontaneous bacterial peritonitis (SBP), although ascitic cultures remained negative. Four of four blood-culture bottles grew V. parahaemolyticus. He denied raw seafood ingestion but had worked as a fish cleaner for two years with frequent minor skin lacerations. Bacteremia cleared and ascitic neutrophilia improved with cephalosporin and doxycycline therapy, but his course was complicated by progressive multiorgan failure and subsequent Candida glabrata fungemia. He died after transition to comfort-focused care.Discussion The concurrent bacteremia and marked culture-negative neutrocytic ascites raise the possibility of hematogenous peritoneal involvement, but organism-specific SBP could not be microbiologically confirmed. Occupational inoculation through disrupted skin was considered a plausible portal of entry.Conclusion In patients with cirrhosis and sepsis, clinicians should assess occupational and environmental marine exposures even when seafood ingestion is absent and should avoid attributing culture-negative SBP to a bloodstream isolate without direct peritoneal microbiologic confirmation.
SN - 2214-2509
ER -