Travel-related sepsis with colitis and necrotizing skin and soft tissue infection after oysters consumption

We describe in this article a case of a 55-year-old woman admitted to our hospital in France, for oedema and paraesthesia of the lower limbs after returning from a trip to Florida. In only four hours, the patient's condition evolved into a multiple organs failure, leading the physicians to carry out a TAP scan and a CT angiogram of the lower limb, which showed acute pan-colitis and diffuse infiltration of the skin and soft legs tissues. Leg fasciotomy was performed and revealed necrotizing fasciitis and myonecrosis. The evolution was unfavorable, leading to shock and death 12 h after hospital admission. Culture revealed Vibrio vulnificus and rapid genome sequencing led to identification of MO6-24/O genotype. V. vulnificus is a bacterium commonly found in warm coastal water and responsible for necrosis SSTI after exposure to seawater through skin lesions and gastroenteritis after ingestion of contaminated seafood. Strain MO6-24/O found in our patient is associated with very poor prognosis. This case is uncommon in Europe but the modification of geographic distribution due to warming coastal waters in Pacific and Atlantic coastal regions of the northern hemisphere lead to consider V. vulnificus in travellers from coastal and estuarine regions, with history of exposure to water or seafood consumption, especially during the summer.