Skin and Soft Tissue Infections: A Case of Necrotizing Fasciitis

Necrotizing fasciitis is a rapidly progressing soft tissue infection associated with a high rate of mortality. Vibrio vulnificus, a gram-negative bacillus found in warm seawater, is a rare but serious cause of necrotizing fasciitis. Definitive treatment is often delayed because of the vague clinical manifestations associated with the early stages of the disease. Delays in diagnosis are directly associated with increased mortality. Because infection with V. vulnificus progresses more rapidly than other causes of necrotizing fasciitis, patients presenting with soft tissue symptoms and who have been in contact with raw seafood or seawater should be considered at high risk for V. vulnificus-associated necrotizing fasciitis. Health care providers in northern and inland areas must be aware of patients who have recently traveled to regions where V. vulnificus is more common, such as warm coastal regions. Early fasciotomy, debridement, and culture-directed antimicrobial therapy are essential to improve survival. The case presented in this report highlights the importance of early diagnosis of V. vulnificus-associated necrotizing fasciitis.