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Experience of six patients with Vibrio vulnificus septicemia
Abstract:
Vibrio vulnificus, a halophilic lactose fermenting vibrio, is a virulent pathogen for men and is frequently associated with overwhelming infections of areas other than the gastrointestinal tract. We encountered six cases of Vibrio vulnificus septicemia in Veterans General Hospital-Taipei over the past four years. All were admitted through the emergency room and presented with urgent conditions on arrival. The patients also demonstrated preexisting liver function impairment (either hepatic disease or chronic alcohol consumption). Five subjects had an apparent history of exposure to marine environments: one fisherman with pre-existing wounds and four others with previous consumption of poorly cooked seafood. Characteristic hemorrhagic bullous lesions were found in 5 cases. In all, 4 patients (67%) died with three of the cases within 24 hours of hospitalization. Misdiagnosis and delayed treatment were the most common causes. In conclusion, when patients present with sepsis and/or characteristic cutaneous lesions, particulously those with underlying liver disease and a history of marine exposure, clinicians should be alerted to this potentially fatal infection and should commence appropriate assessment and treatment immediately.
Insights
Vibrio vulnificus septicemia, a severe infection often fatal, disproportionately affects individuals with liver disease and marine exposure. Early recognition and prompt treatment are crucial for survival.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Public Health
Background:
- Vibrio vulnificus is a virulent, halophilic, lactose-fermenting bacterium.
- It causes severe, non-gastrointestinal infections, particularly in immunocompromised individuals.
Observation:
- Six cases of Vibrio vulnificus septicemia were identified over four years.
- Patients presented with urgent conditions, often with pre-existing liver impairment (hepatic disease or alcohol abuse).
- Five patients had marine environment exposure (fishing or consuming undercooked seafood).
Findings:
- Hemorrhagic bullous lesions were a characteristic finding in 5 cases.
- A high mortality rate of 67% was observed, with 3 deaths within 24 hours of admission.
- Misdiagnosis and delayed treatment were identified as primary contributors to mortality.
Implications:
- Clinicians must consider Vibrio vulnificus in patients with sepsis and/or cutaneous lesions, especially those with liver disease and marine exposure.
- Prompt diagnosis and immediate, appropriate treatment are critical for improving patient outcomes.
- Raising awareness of this potentially fatal infection is essential for public health and clinical practice.