Neonatal diarrhea caused by Vibrio cholerae 0139 Bengal

Abstract

Cholera rarely occurs in children under 2 years of age. We describe diarrhea due to Vibrio cholerae 0139 Bengal, the newly described etiologic agent of cholera in a 4-day-old breast-fed baby. However, the diarrhea was mild and was successfully treated with rehydration therapy and erythromycin.

PIP: Cholera due to Vibrio cholerae 01 has been endemic in Bangladesh. In endemic cholera, the most susceptible age group is children aged 3-5 years, while those under age 2 years are rarely affected. Breast-fed children are protected from cholera due to the lack of extraneous contamination of breast milk and the protective effect of breast milk antibodies. The authors describe the case of diarrhea due to Vibrio cholerae 0139 Bengal in a 4-day old infant admitted to the Clinical Research and Service Center of the International Center for Diarrheal Disease Research, Bangladesh, for treatment. Vibrio cholerae 0139 Bengal caused large epidemics of clinical cholera in India during 1992-93, and is now established as the second etiologic agent of cholera. The male baby from a poor, rural family of Bangladesh was born at term, weighed 2.1 kg, and was breast fed. He had a history of watery diarrhea for the preceding 2 days and evidence of jaundice, but no indication of abnormality based upon systemic examination. After isolating V. cholerae 0139 in a stool specimen, the baby was treated with a total of 300 ml IV cholera saline and oral erythromycin, after which he recovered from diarrhea and was discharged on the third day after admission.