Vibrio vulnificus septicemia and leg ulcer

Vibrio vulnificus is a gram-negative bacteria that can cause septicemia, wound infection, or a self-limiting diarrhea. This infection typically presents as an extremely virulent infection in patients with underlying liver disease 1 to 2 days after exposure. We report a case of V vulnificus septicemia, cellulitis, and leg ulceration in a patient who had symptoms develop after exposure to brackish water (19 days before admission) or after ingestion of raw oysters (10 days before admission). The longest incubation period previously reported is 6 days. The diagnosis was made from identification of the bacteria from blood cultures. No organisms were seen or grown in culture from the skin biopsy specimen, which showed epidermal necrosis and dermal and subcutaneous neutrophilic abscess. We review 13 cases of V vulnificus septicemia and leg ulcers and their approximate incubation time.