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A case of Vibrio cholerae non-O1 septicemia is described in this paper. A 45-year-old male with a three year history of liver cirrhosis, was admitted to our division with hematemesis, abdominal pain, high fever and a loss of consciousness. Three days before onset of symptoms, he traveled to Ishigaki Island and ate a raw lobster. Two days after, his temperature rose to 39.7 degrees C and the blood pressure dropped to 36/- mmHg. By endoscopic examination, an ulcer was found in the stomach, and the bleeding was stopped by electrical coagulation. Blood culture showed growth of V. cholerae non-O1. The organism was found to be sensitive to OFLX, CZX, MINO, LMOX and CP. Although DIC, infections of fungus and MRSA occurred as complications, he recovered by adequate procedures. Subsequently, he left this division after eight weeks. There are various reports related to V. cholerae non-O1 septicemia in foreign countries, but few cases have been reported in Japan. And these cases had severe underlying diseases such as leukemia and liver cirrhosis.
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PMID:[A case of Vibrio cholerae non-O1 septicemia with liver cirrhosis]. 140 1

Between October 1987 and March 1988, research assistants used the explanatory model interview for classification to interview households in 2 villages in Banna subdistrict and 3 villages in Sam-Tai subdistrict in Ayutthaya province, Thailand. Researchers analyzed the data to examine the respondents' diarrhea-related perceptions, beliefs, and practices. The people used 12 terms for diarrhea. The mean number of terms/person was 6. Everyone used the term tong-sia (generic diarrhea). The Ministry of Public Health used the term ahiwa (severe diarrhea such as cholera) in its health education campaigns but only 39.3% of the people knew this term. 99.1% attributed a transitional phase in normal growth and development to be the cause of taae-tua. Bad child's and mother's food was frequently perceived as the cause of ahiwa, tong-sia, and bid (colicky abdominal pain). Everyone, 93.1%, and 67.5% mentioned flies and germs (sanitation and hygienic practices) as the cause of ahiwa, tong-sia, and bid, respectively. The responses were different between theory and actual practice, however. For example, 91% believed bad food and poor sanitation and hygiene were responsible for tong-sia, but only 34.4% gave this response when referring to index cases. Few people attributed supernatural causes or sorcery to bring about diarrhea illness. Most villagers were impressed with modern drugs and injections but they did not understand their nature. They sought treatment from professional sources that should know appropriate diarrhea treatment but did not. Only 51% used oral rehydration solution (ORS) to treat diarrhea and just 3.5% of them believed ORS to be the most useful treatment. Health education efforts should include descriptions of cholera rather than using the work ahiwa, emphasis on the need to treat diarrhea regardless of its perceived cause, promotion of improved sanitation and hygiene, and communication of appropriate expectations of ORS and its ability to prevent and ameliorate dehydration and reduce mortality.
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PMID:Cultural study of diarrhoeal illnesses in central Thailand and its practical implications. 178 75

Between August 24-October 20, 1985, an outbreak of acute diarrheal disease occurred among 1833 children in Imphal, Bishenpur, and Thoubal districts in Manipur State in India for an overall attach rate of 2/1000. 17 children died, a case fatality rate of 9/1000. Hospital and health center personnel treated 1711 cases with rehydration therapy (oral or intravenous fluids). Local, mainly unqualified, practitioners treated the remaining 122 cases with antidarrheal drugs. Children treated at home were more likely to die than those treated at health facilities (case fatality rates 0.6% vs. 4.9%; p.001). Nevertheless these case fatality rates were lower than those in a 1973-1974 outbreak of gastroenteritis in Manipur, perhaps because the health authority distributed oral rehydration solution packets during this 1985 epidemic. The leading symptoms were watery diarrhea (82.5%), vomiting (67.5%), and abdominal pain (37.5%). Children 5 years old tended to experience severe dehydration more so than younger children (31.3% vs. 12.5%). 58.8% of hospitalized cases were older children who suffered the highest death rate. (1.9%). Peak admissions occurred the last week of September ending on October 2. Yet during the decline phase, the admission rate of children 2 years old rose. 25.3% of cases sampled recovered V. cholerae with the highest isolation rate (30.8%) found in older children and adults. 50% of fecal samples of children 6-23 months old tested positive for rotavirus. The researchers did not find any obvious epidemiological link between the 3 areas. They concluded that the rotavirus epidemic which peaked the week after that of cholera represented the beginning of the usual rotavirus diarrhea season.
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PMID:Report of an outbreak of diarrhoeal disease caused by cholera followed by rotavirus in Manipur. 210 90

From January 1983 to March 1988, 26 isolates of Vibrio spp. were recovered from the blood of patients admitted to Siriraj Hospital. Thirteen strains were identified as non 0-1 Vibrio cholerae, 3 were Vibrio vulnificus and 10 were Vibrio spp. The medical records of 20 patients were available for clinical analysis. Most of them were adult men with cirrhosis. Clinical features included fever, abdominal pain, diarrhea, peritonitis, shock and skin lesions. Some patients had a history of seafood consumption or seawater exposure. The isolates were sensitive to commonly used antibiotics. All patients except one received at least one antibiotic that was sensitive in vitro. However, the case fatality rate was still high, 50 per cent. Clinicians should be aware of the clinical syndrome caused by Vibrio spp. in order to manage those patients promptly and appropriately.
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PMID:Vibrio bacteremia in Siriraj Hospital. 238 Jun 45

In chinese medicine, Phellodendri Cortex (Phellodendron amurense Ruprecht) has been used to treat the patient who suffers from gastroenteritis, abdominal pain or diarrhea. Berberine has been identified as a major component in this plant, and it has biological activities, such as bactericidal activity, anti-cholera toxin effect, anti-inflammatory effect, stimulative effect of bile secretion or bilirubin discharge. In the previous study, we have shown the presence of anti-inflammatory activity in the berberine-free fraction of the extract from this plant. In the present study, we also found anti-ulcer activity in the fraction. The fraction significantly inhibited the formation of ethanol-induced ulcer, aspirin-induced ulcer (s.c., p.o.), pylorus-ligated ulcer (p.o., i.d.) in rats, as well as that of stress ulcer in restrained and water-immersed mice (p.o.). In addition, gastric acid secretion was significantly reduced in pylorus-ligated rats by subcutaneous or intraduodenal administration of the fraction, but not by oral administration. These findings suggest that the suppression of ulcer formation may be due to the additive effect of the cytoprotection effect and the reduction of gastric acid secretion by administration of the berberine-free fraction.
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PMID:[Anti-ulcer effect of extract from phellodendri cortex]. 260 17

A case report is presented of a 73-year-old male who was seen with fever, jaundice, abdominal pain and central nervous system depression. He failed to respond to intensive antibiotic therapy, and subsequently acute obstructive suppurative cholangitis fully developed. Upon laparotomy, the patient's gallbladder was found to be enlarged with the bile from the gallbladder and bile duct itself containing a high pus content. Its cultured organism revealed non-0-1 Vibrio cholerae. To our knowledge, no prior case of acute obstructive suppurative cholangitis in a non-0-1 Vibrio Cholerae biliary carrier has been reported in Japan.
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PMID:A case report of acute obstructive suppurative cholangitis in a non-0-1 Vibrio cholerae biliary carrier. 280 12

To determine the role of Vibrio cholerae as a cause of diarrheal illness in Cancun, Mexico, an investigation was conducted in July and August 1983. Although toxigenic V. cholerae 01 were not found, non-01 V. cholerae were isolated from 22 (16%) of 134 stools from persons with diarrheal illness and none of 22 stools from well persons; 58 (92%) of 63 sewage samples; 12 (86%) of 14 untreated well water samples; a home storage tank for treated water; and 5 (21%) of 24 samples of raw seafood. None of the V. cholerae isolates from patients were toxigenic. The illness occurred mainly in small children, and were characterized principally by diarrhea and abdominal pain. No patient was seriously ill, and all recovered without sequelae. Seven different serotypes of non-01 V. cholerae were isolated from the stool specimens, and Smith serotype 12 accounted for 10 (46%) of the 22 isolates. A matched-pair case-control study found that cases were more likely than controls to have eaten home prepared gelatin (P = 0.03, OR = 5/0) and seafood (P = 0.06, OR = 4/0).
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PMID:Non-01 Vibrio cholerae infections in Cancun, Mexico. 382 98

The case of a 25-year-old patient is reported who suffered from a syndrome similar to immune complex disease following cholera revaccination. The clinical picture included fever, muscle, joint and abdominal pain, vomiting, serositis, hepatitis, suspected myocarditis, anaemia and thrombocytopenia. Clinical symptoms subsided spontaneously within two weeks. This case illustrates a hazard of cholera vaccination so far not reported in the literature.
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PMID:Episode resembling immune complex disease after cholera vaccination. 623 47

The authors studied the frequency of diarrheal illness associated with non-typhi Salmonella at two clinics in Bangladesh for the years 1977-1979. Non-typhi salmonellae were isolated from 0.29% of fecal specimens or rectal swabs in an urban area and 0.26% of similar specimens in a rural area; the frequency of isolations peaked in the summer months. Isolations of Shigella and Vibrio cholerae were much more common than Salmonella. Only two of 50 Salmonella isolates were resistant to more than one antibiotic. None of 13 isolates tested produced an enterotoxin. S. java and S. virchow accounted for 64% of all the isolates. Patients with diarrheal illness associated with isolation of Salmonella frequency had vomiting (88%), watery diarrhea (78%), abdominal pain (61%), and fever (39%), but the clinical features of the illnesses and the socioeconomic backgrounds of the patients could not be distinguished from those of matched controls who were attending the same clinic. The infrequency of Salmonella infection in an area where several other bacterial and viral enteric diseases are hyperendemic requires further investigation.
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PMID:Salmonellosis at rural and urban clinics in Bangladesh: epidemiologic and clinical characteristics. 711 37

Between the period January 1991 to June 1993, there were 23,976,238 travellers who arrived from overseas to Narita Airport, of which 20,501 stool specimens were collected from diarrheal patients for bacteriological examination, and infectious agents were detected from 2,751 cases (13.4%) including 250 cases (1.2%) of Vibrio cholerae non-O1. Countries suspected of infection of these patients were Thailand, the most in number, and followed by Indonesia, India and so on these mostly distributed in South-east or South Asia. About fifty percent of the patients were associated with abdominal pain and some with vomiting or fever. Diarrhea was mostly mild except in 16 patients who had severe diarrhea of more than ten times a day. 237 of the 250 isolated V. cholerae non-O1 strains were classified into 48 serogroups. There were 2 rough strains and 11 other strains which were out of the confirmed serogroups. Positive rate of these strains to haemolysin, cholera toxin (CT) and NAG-ST tests were 87.2, 0.4 and 0.8% respectively.
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PMID:[Studies on Vibrio cholerae non-O1 isolated from diarrheal patients arrived from overseas]. 761 8


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