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I am poured out like water, and all my bones are out of joint: my heart is like wax; it is melted in the midst of my bowels.
—The Bible: Psalms 22:14
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This group of curved Gram-negative rods includes Vibrio cholerae, the cause of cholera, one of the first proven infectious diseases, along with Helicobacter pylori and Campylobacter jejuni, newcomers incriminated as pathogens late in the 20th century (Table 32–1). The peptic ulcer disease now known to be caused by H pylori had been long accepted to be due to stress and disturbed gastric acid secretion. Campylobacter jejuni is one of the most common causes of diarrhea in virtually every country of the world. Cholera has undergone a resurgence in recent decades, spreading from its historic Asiatic locale to the Americas, including the coastline of the United States.
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Vibrios are curved, Gram-negative rods (Figure 32–1) commonly found in saltwater. Cells may be linked end to end, forming S shapes and spirals. They are highly motile with a single polar flagellum, non–spore-forming, and oxidase-positive, and they can grow under aerobic or anaerobic conditions. The cell envelope structure is similar to that of other Gram-negative bacteria. Vibrio cholerae is the prototype cause of a water-loss diarrhea called cholera. Other species causing diarrhea, wound infections, and, rarely, systemic infection are listed in Table 32–2.
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