Hemorrhagic bullae associated with Vibrio vulnificus septicemia. Report of two cases

Bullous lesions associated with Vibrio vulnificus infection developed in two patients, both of whom had hepatic cirrhosis. One patient had a recent history of ingestion of raw oysters, while the other patient had recently exposed skin lacerations to sea water. Both patients died within 24 hours of hospitalization, in spite of antibiotic treatment. Vibrio vulnificus was isolated from blood and bullae in both patients. Histologic examination of skin biopsy specimens revealed epidermal/dermal separation and clusters of bacteria within dermal vessels with a negligible inflammatory response.