TITLE:
Successful Treatment of Neutropenic Enterocolitis from Vibrio fluvialis in Acute Myeloid Leukemia: A Case Report
AUTHORS:
Debei C. Cargando, John S. Delgado
KEYWORDS:
Vibrio fluvialis, Necrotizing Enterocolitis, Febrile Neutropenia
JOURNAL NAME:
Advances in Infectious Diseases,
Vol.15 No.4,
October
17,
2025
ABSTRACT: Introduction: Neutropenic enterocolitis (NEC) is a life-threatening gastrointestinal syndrome characterized by fever, abdominal pain, and neutropenia. While most commonly associated with opportunistic bacteria like Pseudomonas spp., the full spectrum of its etiological agents is not completely understood. This report presents the first documented case of NEC where Vibrio fluvialis is identified as the etiologic agent in a profoundly immunocompromised patient. This finding expands the differential diagnosis for NEC and highlights the potential for environmental organisms to cause severe infections in susceptible hosts. Case Presentation: A 37-year-old male with acute myeloid leukemia (AML) developed profound neutropenia following induction chemotherapy. He presented with high-grade fever, right lower quadrant abdominal pain, and loose, mucoid stools. A computed tomography scan revealed circumferential wall thickening of the ascending colon and cecum, consistent with NEC. Both blood and fecal cultures confirmed the presence of pansensitive V. fluvialis. The patient’s condition significantly improved with broad-spectrum antibiotics, bowel rest, and supportive care. He was successfully treated with a 14-day course of meropenem and was discharged in a stable condition without requiring surgical intervention. Conclusion: This case report highlights V. fluvialis as a rare but significant cause of NEC in an adult with AML. The patient’s positive outcome underscores the importance of a high index of clinical suspicion and a comprehensive microbiological workup in immunocompromised patients presenting with symptoms of NEC. Early diagnosis and targeted antimicrobial therapy are crucial to prevent progression to transmural necrosis and avoid invasive surgical procedures. This report serves as a reminder for clinicians to consider atypical, environmental pathogens in the differential diagnosis of NEC, particularly in patients with a history of travel or dietary exposure to marine products.