Presentation
A review of the microorganism's characteristics, susceptible patient population, and lower extremity manifestations of infection is presented. [pubmed.ncbi.nlm.nih.gov]
Hemorrhagic bullae were present, extending from the hand to the upper arm. He also presented with confusion. [aafp.org]
Case presentation. A 47-year-old man presented to a local hospital with chief complaints of fever, bilateral lower limb pain and diarrhoea. He had no history of foreign travel or known medical problems. [microbiologyresearch.org]
The patient presented transitory improvement, but in the 12th day he presented worsening of symptoms and fungemia by Candida albicans, evolving to death in the 19th day of hospitalization. [scielo.br]
Septicemia is the most common presentation of V vulnificus and accounts for the most fatalities from the bacteria. Prompt diagnosis and treatment are vital to prevent mortality. [mdedge.com]
Entire Body System
- Chills
The patient may also experience fever, chills, fatigue and vomiting. Consuming food that is contaminated with V. vulnificus may occasionally cause fever, diarrhoea, vomiting and abdominal pain. [chp.gov.hk]
This results in widespread haemorrhagic bullae (large blood-filled blisters) with fever and chills, and decreased blood pressure (septic shock). This condition is fatal in about 50% of patients. [dermnetnz.org]
It can cause fever, chills, low blood pressure or skin blisters. This may lead to septic shock, when blood pressure takes a dangerous drop. [edition.cnn.com]
Wound infection symptoms include: Blistering and ulceration Swelling and reddening Fluid build-up Fever Sepsis and shock Symptoms of severe bloodstream infection in susceptible individuals can occur rapidly after ingestion and include: Sudden chills and [dshs.texas.gov]
- Anemia
FetalVibrio vulnificus infection in a patient with aplastic anemia. J UOEH 1983; 5: 95–100. (English Abst.) PubMed CAS Google Scholar 23. [link.springer.com]
Therefore, patients who are carrying illnesses like hemochromatosis and hemolytic anemia represent the biggest risk group for development of infection by this agent. It has no predilection for race, gender or age. [scielo.br]
Patient 4 A 75-year-old man with macrocytic anemia attributable to vitamin B12 deficiency presented with fever, chills, myalgia, and weakness. He reported that a few hours earlier he sustained a puncture wound from a spine of a St. [journals.lww.com]
- Fatigue
The patient may also experience fever, chills, fatigue and vomiting. Consuming food that is contaminated with V. vulnificus may occasionally cause fever, diarrhoea, vomiting and abdominal pain. [chp.gov.hk]
- Asymptomatic
Vibrio cholerae serogroup O139: isolation from Cholera patients and asymptomatic household family members in Bangladesh between 2013 and 2014. PLoS Negl. Trop. Dis. 9, e0004183 (2015). PubMed PubMed Central Google Scholar Deshayes, S. et al. [nature.com]
Gastrointestinal
- Nausea
Signs and symptoms of Vibrio vulnificus infection can include: Watery diarrhea, often accompanied by stomach cramping, nausea, vomiting, and fever For bloodstream infection: fever, chills, dangerously low blood pressure, and blistering skin lesions For [cdc.gov]
Symptoms of gastrointestinal vibriosis include watery diarrhea, abdominal cramps, nausea, vomiting, and/or fever. Symptoms of wound infections are sores that become painful, red, and swollen. [vdh.virginia.gov]
The clinical manifestations more often observed in infections caused by Vibrio are: gastroenteritis: presenting diarrhea (100%), abdominal pain (89%), nausea (76%), vomits (55%), fever (47%), occult blood in stool (29%), headache (24%) and myalgia (24% [scielo.br]
Characteristic symptoms include fever, diarrhea, nausea, and vomiting. [aafp.org]
Five patients exhibited stomachache, nausea, and vomiting. Only one patient exhibited full-blown necrosis (Fig. 3). [bjid.org.br]
Cardiovascular
- Tachycardia
[…] caused by Vibrio are: gastroenteritis: presenting diarrhea (100%), abdominal pain (89%), nausea (76%), vomits (55%), fever (47%), occult blood in stool (29%), headache (24%) and myalgia (24%); sepsis: fever (>90%), hypothermia (<10%), hypotension (100%), tachycardia [scielo.br]
Skin
- Blister
There may be ulcers, blisters or black spots on the skin. The level of pain may be out of proportion to the visible skin changes. The patient may also experience fever, chills, fatigue and vomiting. [chp.gov.hk]
Fluid-filled blisters and deep ulcers may develop. Occasionally there is rapid and severe tissue destruction requiring aggressive surgical cleaning of the wound or amputation. [conditions.health.qld.gov.au]
If blister formation is observed on the skin, debridement should be initiated under general anesthesia. [bjid.org.br]
This results in widespread haemorrhagic bullae (large blood-filled blisters) with fever and chills, and decreased blood pressure (septic shock). This condition is fatal in about 50% of patients. [dermnetnz.org]
It can cause fever, chills, low blood pressure or skin blisters. This may lead to septic shock, when blood pressure takes a dangerous drop. [edition.cnn.com]
- Skin Lesion
Both syndromes demonstrate characteristic skin lesions of the trunk and extremities that present as hemorrhagic bullae and progress to necrotic ulcerations. [pubmed.ncbi.nlm.nih.gov]
Wound infections can occur after skin lesions are exposed to contaminated seawater [4, 5]. [bmcinfectdis.biomedcentral.com]
In people with underlying medical conditions, especially liver diseases, V. vulnificus can infect the bloodstream typically causing fever, chills, decreased blood pressure and blistering skin lesions. [chp.gov.hk]
lesions on the limbs and trunk of the body The risk of severe complications and death in susceptible individuals who succumb to primary septicemia is high (50% mortality). [dshs.texas.gov]
[…] and bullae.12,13 V. vulnificus infection should be considered in patients with sepsis and severe skin lesions, and patients should be asked about raw oyster consumption and seawater exposure.2,12–14 Patients with primary wound infections caused by V. [aafp.org]
- Skin Disease
Vibrio vulnificus — CDC On DermNet NZ Cutaneous toxicity from fish ingestion Other websites Vibrio vulnificus infection – Medscape Books about skin diseases See the DermNet NZ bookstore. [dermnetnz.org]
In patients who are immunocompromised, particularly those with chronic liver disease (especially cirrhosis), immunosuppression, end-stage renal disease, and hematopoietic disorders, V vulnificus can cause life-threatening septic shock and blistering skin [emedicine.medscape.com]
Neurologic
- Headache
Twitter Instagram YouTube LinkedIn Search Home Specialties Topics Multimedia Current Issue Learning/CME Learning/CME CME Triglyceride Lowering with Pemafibrate to Reduce Cardiovascular Risk Case 36-2022: A 30-Year-Old Woman with Decreased Vision and Headache [nejm.org]
The clinical manifestations more often observed in infections caused by Vibrio are: gastroenteritis: presenting diarrhea (100%), abdominal pain (89%), nausea (76%), vomits (55%), fever (47%), occult blood in stool (29%), headache (24%) and myalgia (24% [scielo.br]
- Meningism
Rarely, they are reported in patients with meningitis, pneumonia and infection of reproductive organs or urinary tract [2]. There are no evidences of person to person transmission. [scielo.br]
Besides the above-mentioned presentations, it should be noted that patients may also have atypical presentations including spontaneous bacterial peritonitis, pneumonia, endometritis, meningitis, septic arthritis, osteomyelitis, endophthalmitis, and keratitis [frontiersin.org]
Workup
Serum
- Leukopenia
Other bad prognostic signs included a systolic blood pressure of less than or equal to 90 mm Hg, decreased platelet counts, and leukopenia. The combination of hepatic dysfunction and diabetes mellitus was also associated with a poor outcome. [emedicine.medscape.com]
Our case alerts clinicians to a possible V. vulnificus infection in patients with an unclear infection status, who experience pain of unknown origin in the lower legs, especially if the patient has hypotensive shock, leukopenia, hypoalbuminemia, coagulation [bmcinfectdis.biomedcentral.com]
Park et al (15) Chang et al (8) Tacket et al (12) Number of patients 38 70 14 18 Mean age (years) 62.5 51 53.6 56.4 Age range (years) 23–84 – 23–69 – Sex (male/female) 33/5 67/3 10/4 13/5 Temperature at admission >37.8°C – – – Leukocyte count (/L) – Leukopenia [ncbi.nlm.nih.gov]
Microbiology
- Vibrio Vulnificus
How common is Vibrio vulnificus infection? Vibrio vulnificus is a rare cause of disease, but it is also underreported. [floridahealth.gov]
Review Lower extremity manifestations of Vibrio vulnificus infection T J Laughlin et al. J Foot Ankle Surg. Jul-Aug 1995. [pubmed.ncbi.nlm.nih.gov]
Entry H00308 Disease Name Vibrio vulnificus infection Description Vibrio vulnificus is a gram-negative bacillus found in warm coastal waters. [genome.jp]
There is no evidence of person-to-person transmission of Vibrio vulnificus. [conditions.health.qld.gov.au]
Laboratory
- Leukocytosis
Leukocytosis was defined as a total leukocyte count greater than 12,000/mm3, and erythrocyte sedimentation rate exceeding 30 mm/1 hour was defined as elevated. [journals.lww.com]
[…] skin and soft tissue infections. [18] The presence of hemorrhagic bullous skin lesions, necrotizing fasciitis, primary septicemia, a greater severity-of-illness, absence of leukocytosis, and hypoalbuminemia were found to be the significant risk factors [emedicine.medscape.com]
[…] et al (12) Number of patients 38 70 14 18 Mean age (years) 62.5 51 53.6 56.4 Age range (years) 23–84 – 23–69 – Sex (male/female) 33/5 67/3 10/4 13/5 Temperature at admission >37.8°C – – – Leukocyte count (/L) – Leukopenia 14/59 8 (44%) >1.0×1010* – Leukocytosis [ncbi.nlm.nih.gov]
Treatment
The patients were divided into a survival group and a death group to investigate differences in treatment (Study 3). Medical treatments primarily included antibiotic administration, debridement, and limb amputation. [bjid.org.br]
Journal Int J Infect Dis 15:e157-66 (2011) DOI:10.1016/j.ijid.2010.11.003 Reference PMID:17853628 Authors Bross MH, Soch K, Morales R, Mitchell RB Title Vibrio vulnificus infection: diagnosis and treatment. Journal Am Fam Physician 76:539-44 (2007) [genome.jp]
When treatment was delayed by as little as 24 hours in patients with septicemia, mortality rates increased from 33 to 53 percent. [aafp.org]
Register Vibrio vulnificus Infection in Taiwan: Report of 28 Cases and Review of Clinical Manifestations and Treatment - 24 Hours access EUR €27.00 GBP £20.00 USD $35.00 Rental This article is also available for rental through DeepDyve. [academic.oup.com]
Prompt diagnosis and treatment are vital to prevent mortality. [mdedge.com]
Prognosis
The accuracy of a fatal prognosis at the time of admission was 0.79 (95% confidence interval [CI], 0.59 to 0.92). [jcm.asm.org]
Stool cultures require a thiosulfate citrate bile salts sucrose agar for isolation.24 Treatment and Prognosis The recommended antibiotic therapy for V. vulnificus infection is doxycycline, 100 mg intravenously or orally (Vibramycin) twice a day; plus [aafp.org]
Prognosis Vibrio vulnificus infection is an acute illness that is quickly resolved with antibiotics and does not have any long-term consequences. The prognosis is often excellent with proper treatment. [emedicine.medscape.com]
The prognosis is closely related to the basic clinical condition of the patient, since complications are rare in immunocompetent patients or in gastroenteritis associated to non cholera Vibrio. [scielo.br]
Although abnormalities such as low blood pressure and bleeding tendencies are related to poor prognosis, debridement should be performed within 4h to maximize patient survival. [bjid.org.br]
Etiology
Table 218,19 presents etiologies for the differential diagnosis of aggressive soft tissue infection. Most of these infections involve a group A Streptococcus species or Staphylococcus aureus. [aafp.org]
This new clonal subgroup emphasizes that the fish aquaculture environment, and possibly manmade ecological niches as a whole, may be a source of new pathogenic strains. [6] Etiology See Pathophysiology. It is seen in a variety of seafood. [emedicine.medscape.com]
Epidemiology
Weekly epidemiological record. Weekly epidemiological record 92, 437–452 (2017). World Health Organization. Weekly epidemiological record. Weekly epidemiological record 92, 301–320 (2017). Google Scholar Khan, A. I. et al. [nature.com]
In this study, we sought to define the characteristic epidemiology of V. vulnificus infection and clarify its diagnosis at the global level. [bjid.org.br]
Hlady WG, Klontz KC: The epidemiology of Vibrio infections in Florida. 1981–1993. J Infect Dis 173:1176–1183, 1996. Cited Here 8. Hollis DG, Weaver RE, Baker CN, Thornsberry C: Halophilic Vibrio sp. isolated from blood cultures. [journals.lww.com]
Clinical and epidemiologic features in Florida cases, 1981-1987. Ann Intern Med 1988;109:318â323. 23. Chen Y, Satoh T, Tokunaga O. Vibrio vulnificus infection in patients with liver disease: report of five autopsy cases. [kjim.org]
The epidemiological background for most of the infections except for V cholerae 01 and 0139 is incomplete or lacking. [ncbi.nlm.nih.gov]
Pathophysiology
Its pathophysiology is classified into three types: (1) primary septicaemia, (2) gastrointestinal illness pattern and (3) wound infection pattern. Of these, primary septicaemia is critical. [microbiologyresearch.org]
Pathophysiology V vulnificus infects the body in 2 ways, either by exposure to contaminated seafood, such as raw oysters, or through an open wound exposed to contaminated seawater. [emedicine.medscape.com]
Prevention
Prevention To prevent V. vulnificus infection, members of the public, in particular, people with impaired immune response or with underlying medical illnesses, should observe the following: Proper wound management Clean wounds immediately and cover properly [chp.gov.hk]
How can vibriosis be prevented? People should not consume raw or undercooked seafood. [vdh.virginia.gov]
Prevention You can reduce your risk of infection. Avoid wounds coming into contact with warm seawater or brackish water. Cover wounds with a waterproof bandage. Cleanse wounds thoroughly with soap and water if exposed to brackish water or seawater. [health.govt.nz]
What are some tips for preventing Vibrio vulnificus infections? Do not eat raw oysters or other raw shellfish. Cook shellfish (oysters, clams, mussels) thoroughly. [floridahealth.gov]
One spike came after Hurricane Katrina in 2005, according to the US Centers for Disease Control and Prevention, when people were also exposed to Vibrio vulnificus in floodwaters. [edition.cnn.com]