Vibrio vulnificus infection is the leading cause of death related to seafood consumption in the United States. However, 25 per cent of V. vulnificus infections are caused by direct exposure of an open wound to warm seawater containing the organism.
- This is a marine-borne motile, curved rod-shaped gram-negative
- Sepsis in the immunocompromised host
- Particularly seen in cirrhotic patients.
- Acquired by direct wound inoculation or ingestion via raw
- V. vulnificus is related to V. cholerae
- Present in estuaries, brackish ponds, or coastal areas
- Main route is Ingestion of infected seafood consumption in the United States.
- Other 25% caused by direct exposure of an open wound to infected warm seawater
Clinical: severe blisters
- Watery diarrhoea, cramping, nausea, vomiting, and fever
- Fever, chills, hypotension, blistering skin lesions
- Sepsis and severe deep painful cellulitis with rapid development to ecchymoses and bullae.
- Necrotizing fasciitis can develop. Purpura fulminans
- FBC, U&E, LFT, CRP, Cultures
- Antibiotics: Doxyxycline, Vibramycin, Ceftazidime
- Aggressive wound therapy, and supportive care.
- Surgical debridement, Limb amputation may be needed
- Mortality is >50%, even with appropriate and early antibiotics.
- Patients with painful, rapidly progressive hemorrhagic bullae should receive prompt surgical evaluation for possible debridement.