Lassa Fever, Nigeria, 2003 and 2004

The patient was successfully extubated. He was transferred to a pneumology ward on day 9 and discharged on day 15. Antimicrobial treatment was stopped on day 10. Most nonhuman strains of V. metschnikovii are usually found in aquatic habitats (e.g., lakes and marine waters). Human clinical infections with this bacterium are rare; however, cases of epidemic diarrhea caused by V. metschnikovii have been reported (5,6). Contamination by water or fish was not always demonstrated in these cases, but an orofecal source is possible. In coproculture, this microorganism is probably not diagnosed: it was initially identified as normal aerobic flora because it was oxidase negative. The first case of septicemia with V. metschnikovii was reported in 1981 in a patient with peritonitis and an inflamed gallbladder (1). Three other patients with similar septicemia, all >70 years of age, were described (7,8); 2 had polymicrobial results in blood cultures. V. metschnikovii was also found in a mucocutaneous site (wound infection) after saphenectomy in swab samples of the wound site (9). The patient in our study denied contact with lake or sea water, and he had not eaten any seafood. He was a retired carpenter without contact with domestic or wild animals and did not recall an episode of diarrhea before his hospitalization. The source of contamination that caused his acute respiratory failure was not identified. Miyake et al. showed that V. metschnikovii produces a cytolysin with hemolytic properties (10). This finding might explain the invasive process of this bacterium, which resulted in pulmonary lesions in a patient with respiratory deficiency. As far as we know, this is the first case of pneumonia caused by V. metschnikovii. Frédéric Wallet,* Mickaël Tachon,* Saad Nseir,* René J. Courcol,* and Micheline Roussel-Delvallez* *Lille University Medical Center, Lille, France