Vibrio vulnificus
Background
- History of handling or ingestion of raw seafood (most commonly oysters)
- Handling: rapid cellulitis that progresses to hemorrhagic bullae and purpura fulminans
- Ingestion: vomiting, diarrhea, or abdominal pain, and may present with fever, chills, or shock
- Patients with cirrhosis at high risk
- Severe Complications[1]
- Necrotizing fasciitis and septicemia
- Immediate and intensive empirical antibiotic treatment
- Surgical debridement in suspected cases
Vibrio species
Background
- Gram negative bacterium living in marine environments
- Leading cause of shellfish-associated death in US
Clinical Features
- Fever, septic shock, bullous skin lesions
- Wound infections can spread rapidly causing severe myositis and necrotizing fasciitis
- More commonly seen in high risk patients: liver disease, alcoholism, hemochromatosis
- Exposure to marine/estuarine water, ingestion of raw/undercooked shellfish (oysters)
Differential Diagnosis
Evaluation
Management
- Severe infections should be treated with immediate antibiotics and ICU admission
- May require aggressive surgical debridement
Antibiotic Sensitivities[2]
Key
- S susceptible/sensitive (usually)
- I intermediate (variably susceptible/resistant)
- R resistant (or not effective clinically)
- S+ synergistic with cell wall antibiotics
- U sensitive for UTI only (non systemic infection)
- X1 no data
- X2 active in vitro, but not used clinically
- X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
- X4 active in vitro, but not clinically effective for strep pneumonia
Table Overview
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See Also
References