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Subject: Vibrio Culture of Stool (Rule out)
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Vibrio species are an uncommon cause of bacterial enteric infections in this country, but endemic infections occur in many countries. Epidemic outbreaks are well described, generally associated with inadequately treated sewage or contaminated water. Vibrio species are halophilic, and brackish water and shellfish serve as an important reservoir for organisms. Although infection may be relatively mild and self-limited, some patients develop cholera: severe disease with vomiting and profuse watery diarrhea (rice water stools). The severe diarrhea may rapidly lead to life-threatening dehydration and electrolyte imbalance. Stool culture to rule out Vibrio species should be considered for patients who develop diarrhea, especially severe watery diarrhea, after travel to an endemic area, ingestion of contaminated sea food, or exposure to brackish water.
This culture is used to detect enteric infection caused by Vibrio cholerae or related Vibrio species. Specimens are inoculated on the thiosulfate citrate bile sucrose (TCBS) medium, a differential and selective medium for Vibrio isolation. Broth enrichment using alkaline peptone water may be used to improve isolation. Colonies from routine stool culture may be screened for cytochrome oxidase–positive isolates, which should be further tested to rule out Vibrio species.
Turnaround time: Cultures are incubated for 48 hours. Additional time is required for isolation and identification.
Expected results: No growth.
Vibrio enteric infection may be missed if specific cultures are not requested.