Vibrio alginolyticus: a dire infection in a beachboy from a coastal island in Malaysia

• Main Authors: Ahmad Tajudin, Edahayati, Mokhtar, Nur Aqilah, Faisal, Ummu Salamah, Zainulabid, Ummu Afeera
• Format: Proceeding Paper
• Language: English
• Published: 2023
• Subjects: RC111 Infectious and Parasitic Diseases
• Online Access: http://irep.iium.edu.my/105608/30/105608_Vibrio%20alginolyticus%20A%20dire%20infection%20in%20a%20beachboy.pdf; http://irep.iium.edu.my/105608/; https://www.eccmid.org/
• Institution: Universiti Islam Antarabangsa Malaysia

Background: One of the most prevalent pathogenic marine Vibrio species, Vibrio alginolyticus has been linked to necrotizing soft tissue infections, bacteremia, septic shock, and numerous organ failures in humans. Here we highlight a case of left ankle abscess secondary to V. alginolyticus in a beachboy from a coastal island in Langkawi, Malaysia. Case(s) description: A 38-year-old beach boy at Cenang Beach, Langkawi, presented with worsening left ankle swelling for four days, which the swelling was noticed for the past 6 months. It was associated with minimal pus discharge. Further history revealed that he had trauma to his left ankle where he bumped the coral reef while working at the ocean. At presentation, he is febrile and hemodynamically unsupported. The left lower extremity examination revealed a well-circumscribed erythematous swelling over the left lateral malleolus measuring 4 x 5 cm with a shiny surface. It was warm, fluctuant, and tender with the presence of haemoserous discharge. The erythematous areas extended to the dorsal surface of the left leg. Blood investigation showed a white cell count of 10.5 x109/L, hemoglobin of 14.9 g/dL, and platelet of 271 x10^9/L with normal liver and renal function tests. The patient underwent an incision and drainage for the left ankle abscess, and intraoperative tissue and pus samples were sent for culture and sensitivity. The next day, greyish round colonies grew on blood agar with no growth on MacConkey agar. Gram stain revealed a small gram-negative rod. Further identification using thiosulfate-citrate-bile salts sucrose (TCBS) agar showed large yellow-pigmented colonies, with positive oxidase tests. The isolate was identified using API 20NE and revealed Vibrio alginolyticus with 96.5% percentage discrimination. He was treated with Bactrim considering antibiotic susceptibility results and recovered well. Discussion: The Gram-negative halophilic bacterium V. alginolyticus is ubiquitous in the aquatic environment, especially in temperate waters. It can even thrive in highly salty environments. Considering this evolving pathogen in patients with skin or soft tissue lesions with a history of exposure to seawater and otherwise healthy individual is essential. In addition, new cases need to be reported to determine if the incidence is also increasing in our country and other regions.