Vibrio vulnificus Bacteremia With Compartment Syndrome: A Case Report and Characterization of the Isolate

Vibrio vulnificus is a Gram-negative, curved, rod-shaped organism that can cause sepsis due to either gastroenteritis when ingested (usually via raw oysters) or skin infections when introduced into cuts or abrasions. Found in estuarine waters (coastal waters where fresh water from streams mixes with salt water from the ocean resulting in water of intermediate salinity (i.e., brackish water)), it most commonly causes clinical disease in individuals with cirrhosis, diabetes, or other immunocompromised states. Here, we describe the case of a 59-year-old male, with known heavy alcohol use and hypertension, who presented to the emergency department with acute cellulitis and compartment syndrome of his right leg due to V. vulnificus. He had a rapidly fatal course despite aggressive surgical and medical care. We describe his clinical course, identify sequence relatedness, and detail the characterization of the toxins expressed by his isolate. Early consideration of V. vulnificus infections is important in reducing morbidity and mortality in high-risk patients; however, even with early detection and treatment, mortality remains high. Improving survival will require a better understanding of the host, bacteria, and environmental factors that determine clinical outcomes. This will require improved coordination between clinicians, microbiologists, and basic scientists.