PROBABLE GALLBLADDER INFECTION IN CONVALESCENT CHOLERA PATIENTS

Abstract Forty-three cholera patients have been investigated during convalescence as possible asymptomatic vibrio carriers, thirty-four in the immediate postinfection period, eight approximately 1 year later, and one on both occasions. Duodenal intubation and purging were performed in twenty-eight cases, intubation alone in four studies, and purging alone in twelve studies. Two asymptomatic vibrio carriers were found. One patient had positive stool cultures for Vibrio cholerœ after purging with magnesium sulphate on seven occasions over a 23-week period, starting 9 days after his last routine positive rectal swab culture. During the entire 23 weeks he had negative stool cultures except after purging. The second patient was first intubated on the 4th day after his last positive stool culture and on two occasions over a 2-week convalescent period had V. cholerœ cultured from the resultant duodenal aspirate only after being given intravenous cholecystokinin. After both duodenal aspirations, purges by magnesium sulphate also yielded vibrio-positive stools. All subsequent specimens following intubation and purging were negative for vibrios. These two patients, neither of whom received antibiotic therapy, are too few to confirm the efficacy of antibiotics in eradicating vibrios from the cholera patient. The observations do indicate that the gallbladder may harbour vibrios in convalescent cholera patients. The existence of such carriers may well explain recurrence and transmission of cholera.