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Vibrio vulnificus septicemia.

T J Hoffmann1, B Nelson, R Darouiche

  • 1Dermatology Service, Veterans Administration Medical, Houston, TX.

Archives of Internal Medicine
|August 1, 1988
PubMed
Summary
This summary is machine-generated.

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A Vibrio vulnificus infection occurred in an alcoholic man with cirrhosis after a shrimp injury. The infection caused septic shock and severe skin tissue destruction, highlighting the risks of Vibrio vulnificus.

Area of Science:

  • Infectious Diseases
  • Dermatology
  • Hepatology

Background:

  • Vibrio vulnificus is a marine bacterium that can cause severe infections, particularly in individuals with compromised immune systems or liver disease.
  • Laennec's cirrhosis is a common complication of chronic alcoholism, leading to significant liver dysfunction and increased susceptibility to infections.
  • Exposure to marine environments, especially the Gulf of Mexico, presents a risk for Vibrio vulnificus exposure through wound contamination.

Observation:

  • A middle-aged male patient with Laennec's cirrhosis and a history of alcoholism presented with symptoms of septic shock.
  • The patient sustained a puncture wound from a shrimp shell while fishing in the Gulf of Mexico.
  • Clinical presentation included acrally distributed urticarial plaques, purpura, bullae, and signs of severe sepsis.

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Findings:

  • Vibrio vulnificus was successfully isolated from the patient's blood.
  • Histologic examination of skin biopsy revealed a devitalized, cell-poor superficial dermis with acute cellulitis and extensive tissue destruction.
  • Necrotizing vasculitis with numerous bacilli surrounding dermal vessels was a prominent finding.

Implications:

  • This case underscores the critical risk of severe Vibrio vulnificus infection in patients with cirrhosis and alcoholism.
  • Prompt recognition and management of Vibrio vulnificus infections are crucial, especially in individuals with risk factors and relevant exposure history.
  • The findings emphasize the aggressive nature of Vibrio vulnificus, leading to rapid tissue destruction and systemic illness.