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Detection of V. vulnificus septic shock with ARDS using mNGS
Tangjun Dan1, Haidong Qin1, CaiZhi Sun1
1Department of Emergency Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Abstract:
The latest surveillance from the Centers for Disease Control and Prevention shows that the annual incidence of V. vulnificus infection is increasing. Unfortunately, in less well-known high-risk groups, this infection is usually excluded from differential diagnosis. Transmitted through wound exposure or ingestion, the mortality rate of foodborne diseases of V. vulnificus is the highest of all V. vulnificus. V. vulnificus is as lethal early diagnosis as Ebola and bubonic plague, so timely treatment is imperative. Sepsis caused by V. vulnificus infection mainly exists in the United States and is rarely reported in Southeast Asia. We report a 78-year-old man who went to the local hospital and complained of swelling in his right hand with severe pain. He ate raw salmon 2 days ago and denied other recognized seafood stab or trauma history and other seafood contact history. He was in septic shock at the time of treatment, so we immediately transferred to the emergency intensive care unit and tested for metagenomic next-generation sequencing (mNGS). The diagnosis was confirmed the second day after admission, and eventually he was cured and discharged from the hospital only after medical treatment, thus avoiding the risk of surgical debridement or even amputation. mNGS is helpful for early clinical diagnosis and effective early intervention for etiology, so that patients can get a good prognosis.
Insights
Vibrio vulnificus infections are increasing and often missed in high-risk groups. Early diagnosis using metagenomic next-generation sequencing (mNGS) is crucial for timely treatment and improved patient outcomes.
Area of Science:
- Infectious Diseases
- Microbiology
- Genomics
Background:
- The incidence of Vibrio vulnificus infections is rising, yet often overlooked in certain high-risk populations.
- Vibrio vulnificus infections, particularly foodborne, have a high mortality rate, comparable to Ebola and bubonic plague.
- Sepsis from V. vulnificus is primarily reported in the US, with rare occurrences in Southeast Asia.
Observation:
- A case study of a 78-year-old male presenting with severe hand swelling and pain after consuming raw salmon.
- The patient presented in septic shock, necessitating immediate transfer to the intensive care unit.
- Metagenomic next-generation sequencing (mNGS) was employed for rapid etiological diagnosis.
Findings:
- mNGS confirmed the V. vulnificus diagnosis within 24 hours of admission.
- The patient received medical treatment, avoiding surgical intervention such as debridement or amputation.
- Successful treatment led to the patient's recovery and discharge.
Implications:
- Metagenomic next-generation sequencing (mNGS) significantly aids in the early and accurate diagnosis of V. vulnificus infections.
- Early etiological diagnosis facilitates prompt and effective medical intervention.
- Timely treatment based on mNGS results can prevent severe complications and improve patient prognosis, potentially avoiding limb loss.
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