Clinical Infections of Vibrio vulnificus: A Case Report and Review of the Literature

• Published in: The Journal of emergency medicine Vol. 16; no. 1; pp. 61 - 66
• Main Authors: Kumamoto, Kenneth S., Vukich, David J.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.01.1998; Elsevier
• Subjects: Animals; Anti-Bacterial Agents - therapeutic use; Bacteremia - diagnosis; Bacteremia - drug therapy; Bacteremia - etiology; Bacterial diseases; Bacterial sepsis; Biological and medical sciences; Emergency Service, Hospital; Fatal Outcome; Gram-negative rod septic shock; Human bacterial diseases; Humans; Infectious diseases; Leg; Male; Medical sciences; Middle Aged; Ostreidae - microbiology; Pain - diagnosis; Pain - physiopathology; primary septicemia; raw oysters; Shellfish - adverse effects; Shellfish - microbiology; Shock, Septic - diagnosis; Shock, Septic - drug therapy; Shock, Septic - etiology; Vibrio - classification; Vibrio - isolation & purification; Vibrio Infections - diagnosis; Vibrio Infections - drug therapy; Vibrio Infections - etiology; Vibrio vulnificus; Wound Infection - diagnosis; Wound Infection - drug therapy; Wound Infection - etiology; wound infections; Gram-negative rod septic shock; raw oysters; wound infections; primary septicemia; Vibrio vulnificus; Shock; Case study; Human; Cardiovascular disease; Septicemia
• ISSN: 0736-4679; 2352-5029
• DOI: 10.1016/S0736-4679(97)00230-8

Vibrio vulnificus is a marine Gram-negative bacillus that is recognized as a cause of fulminant primary septicemia and wound infections. One of the most common bacteria in seawater, V. vulnificus is concentrated in ocean filter feeders (e.g., oysters and clams). Primary septicemia can occur in patients, typically with underlying liver disease, who have acquired the organism through the gastrointestinal tract after recent consumption of raw shellfish. Characterized by fevers, chills, and bullous skin lesions, V. vulnificus septicemia is associated with a mortality greater than 50%. With septic shock, mortality approaches 100%. Wound infections are seen after injury to the skin in a marine environment or from exposure of preexisting wounds to seawater. Because of the high morbidity and mortality associated with V. vulnificus infections, effective treatment includes preventive measures to educate high-risk individuals, early search for and recognition of the disease, aggressive antibiotic therapy, supportive care, and, in the case of wound infections, aggressive debridement. Review of this subject was prompted by a case of V. vulnificus primary septicemia and fulminant septic shock in a patient with the unusual presentation of pain in the lower extremities.