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[Vibrio vulnificus: an infrequent cause of septic shock]
Rodrigo Poblete1, Max Andresen, Carlos Pérez
1Unidad de Tratamiento Intensivo Médico, Hospital Clínico Universidad Católica de Chile, Departamento de Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica de Chile.
Abstract:
Vibrio vulnificus is a lactose positive Gram negative rod that lives in warm seas and can infect wounds and produce sepsis. Its infection is acquired after eating oysters or other filtering marine organisms. We report a 53 years old diabetic male who started with fever after a voyage to Central America. He was admitted febrile, hypotense, dehydrated and polypneic. Painful erythematous lesions and lumps were observed in his upper and lower limbs. After 72 hours of evolution, the lesions became violaceous, with crepitating vesicles full of hemorrhagic exudate. He developed a renal failure and a disseminated intravascular coagulation. Blood cultures demonstrated the presence of Vibrio vulnificus and the patient died 68 hours after admission.
Insights
A Vibrio vulnificus infection, acquired from marine environments, rapidly led to sepsis and death in a diabetic patient. This case highlights the aggressive nature of Vibrio vulnificus sepsis, particularly in immunocompromised individuals.
Area of Science:
- Microbiology
- Infectious Diseases
- Clinical Medicine
Background:
- Vibrio vulnificus is a Gram-negative bacterium found in warm marine environments.
- Infections are typically acquired through consumption of contaminated seafood or wound exposure.
Observation:
- A 53-year-old diabetic male presented with fever, hypotension, and respiratory distress after traveling to Central America.
- He developed painful, erythematous lesions on his limbs that progressed to violaceous, crepitating vesicles with hemorrhagic exudate.
Findings:
- Blood cultures confirmed the presence of Vibrio vulnificus.
- The patient developed acute renal failure and disseminated intravascular coagulation (DIC).
Implications:
- This case underscores the rapid progression and high mortality rate associated with Vibrio vulnificus sepsis.
- Prompt recognition and aggressive management are crucial for improving outcomes in patients with Vibrio vulnificus infections, especially those with underlying health conditions like diabetes.