A case ofVibrio vulnificus infection

Abstract

Vibrio vulnificus, a recently described strain of the halophilicVibrio species, was isolated from the blood of a 73-year-old man, who developed rapidly progressive wound infection and fatal septicemia. Twenty-one patients withVibrio vulnificus infection have been reported in the Japanese literature.Vibrio vulnificus most frequently causes primary septicemia and necrotising cellulitis after the eating of raw fish or shellfish or after exposure to seawater. The infection is characterized by its occurring during the warm months of the year, in patients with underlying diseases, especially liver diseases, and the mortality rate is surprisingly high. Clinicians should therefore consider the possibility ofVibrio vulnificus infection in the differential diagnosis of severe wound infections. Early surgical intervention and intensive antibiotic therapy are recommended for preventing the progress of the septicemia.

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References

  1. 1.

    Roland FP. Leg gangrene and endotoxic shock due toVibrio parahemolyticusan infection acquired in New England coastal water. N Engl J Med 1970; 282: 1306–1307.

    PubMed  CAS  Article  Google Scholar 

  2. 2.

    Weaver RE, Ehrenkranz NJ.Vibrio parahemolytic septicaemia. Arch Intern Med 1975; 135: 197.

    PubMed  CAS  Article  Google Scholar 

  3. 3.

    Zide N, Davis J, Ehrenkranz NJ. FulminatingVibrio parahemolyticus septicemia. A syndrome of erythema multiforme, hemolytic anemia and hypotension. Arch Intern Med 1974; 133: 479–481.

    PubMed  CAS  Article  Google Scholar 

  4. 4.

    Thorsteinsson SB, Minuth JN, Musher DM. Clinical manifestations of halophilic non-cholera vibrio infections. Lancet 1974; 2: 1283–1284.

    PubMed  CAS  Article  Google Scholar 

  5. 5.

    Fernandez CR, Pankey GA. Tissue invasion by unnamed marine vibrios. JAMA 1975; 233: 1173–1176.

    PubMed  CAS  Article  Google Scholar 

  6. 6.

    Hollis DG, Weaver RE, Baker CN, Thornsberry C. Halophilic vibrio species isolated from blood cultures. J Clin Microbiol 1976; 3: 425–431.

    PubMed  CAS  Google Scholar 

  7. 7.

    Farmer JJ.Vibrio (“Beneckea”)vulnificus, the bacterium associated with sepsis, septicemia, and the sea. Lancet 1979; 27: 903.

    Article  Google Scholar 

  8. 8.

    Blake PA, Merson MH, Weaver RE, Hollis DG, Heublein PC. Disease caused by a marine vibrio. N Engl J Med 1979; 300: 1–5.

    PubMed  CAS  Article  Google Scholar 

  9. 9.

    Kelly MT, Avery DM. Lactose-positive vibrio in seawater: A case of pneumonia and septicemia in a drowning victim. J Clin Microbiol 1980; 11: 278–280.

    PubMed  CAS  Google Scholar 

  10. 10.

    Tison DL, Kelly MT.Vibrio vulnificus endometritis. J Clin Microbiol 1984; 20: 185–186.

    PubMed  CAS  Google Scholar 

  11. 11.

    Wright AC, Simpson LM, Oliver JD. Role of iron in the pathogenesis ofVibrio vulnificus infections. Infect Immun 1981; 34: 503–507.

    PubMed  CAS  Google Scholar 

  12. 12.

    Blake PA. Diseases of humans (other than cholera) caused by vibrios. Annu Rev Microbiol 1980; 34: 341–367.

    PubMed  CAS  Article  Google Scholar 

  13. 13.

    Anderson BR. Host factors causing increased susceptibility to infection in patients with Laennec’s cirrhosis. Ann NY Acad Sci 1975; 252: 348–352.

    Google Scholar 

  14. 14.

    Matsuo T, Kohno S, Ikeda T, Saruwatari K, Ninomiya H. Fulminating lactose-positive vibrio septicemia. Acta Path Jap 1978; 28: 937–948.

    PubMed  CAS  Google Scholar 

  15. 15.

    Kitamura T, Azuma I, Harada N. Isolation of the lactose positive vibrio from the spinal fluid. Rinsho to Saikin 1981; 8 (Suppl.): 98. (in Japanese)

    Google Scholar 

  16. 16.

    Tanigawa N, Fujita K, Kawai K, Tanaka N, Sawada M, Sakaguchi K, Kimura K, Nakanishi H, Murase M, Sakazaki T, Shimada T. A case ofVibrio vulnificus septicemia. J J A Inf D 1981; 55 (Suppl.): 81–82. (in Japanese)

    Google Scholar 

  17. 17.

    Yo K, Tutida T, Takizawa K, Nagano Y. A case of latose-fermenting (Lf) septicemia. J J Derma 1981; (Suppl.): 598. (in Japanese)

  18. 18.

    Konishi K, Yamagishi T, Sakamoto K. A halophilic vibrio isolated from a case of chronic cholecystitis. Microbiol Immunol 1981; 25: 1221–1228.

    PubMed  CAS  Google Scholar 

  19. 19.

    Maeda H, Fukuda K, Irikou K, Horiuchi A, Takenaka S, Furuta K, Ohba Y, Azuma I, Harada N, Kitaura T. A case of hepatoma associated withVibrio vulnificus bacteremia and its bacteriological findings. J J A Inf D 1982; 56: 335–339. (English Abst.)

    CAS  Google Scholar 

  20. 20.

    Takamiya H, Katagiri F, Maekawa K, Ohtani H. Clinical and bacteriological studies on a case with Infectious disease. J J A Inf D 1982; 56: 1032–1037. (English Abst.)

    CAS  Google Scholar 

  21. 21.

    Takeshita Z, Onizuka H, Yonezawa S, Muto M. A fetal case ofVibrio vulnificus septicemia. Eiseikensa 1982; 31 (Suppl.): 541. (in Japanese)

    Google Scholar 

  22. 22.

    Yoshida S, Tanabe T, Yamamoto S, Tiba S, Mizuguchi Y. FetalVibrio vulnificus infection in a patient with aplastic anemia. J UOEH 1983; 5: 95–100. (English Abst.)

    PubMed  CAS  Google Scholar 

  23. 23.

    Suzuki K, Tabe Y, Suzuki O, Mori Y, Satake T, Yamamoto M, Saka Y, Kawase A, Masaki T, Yoshii S, Higashizutsumi M. L (+) Vibrio isolated from blood culture. Rinshyo Byohri 1982; 30 (Suppl.): 992–993. (in Japanese)

    Google Scholar 

  24. 24.

    Kaseda M, Masuda G, Miyakuni Y, Onodera T, Awane Y, Saku K, Motegi H. A case of bacteremia and phregmon due toVibrio vulnificus. J J A Inf D 1983; 57: 750–753. (in Japanese)

    CAS  Google Scholar 

  25. 25.

    Okamoto Y, Ogata M, Shirakawa M, Yano T, Nakahara T, Ogasawara K, Hirai S. Two cases ofVibrio vulnificus sepsis. Kyosaiiho 1983; 32: 528–535. (English Abst.)

    Google Scholar 

  26. 26.

    Iwatani M, Tamaguma M, Ishiyama K, Iwamoto Y, Sakazaki T, Takagi JH. Acute septic shock due toVibrio vulnificus. Kyuhkyuhigaku 1983; 7: 1699–1702. (in Japanese).

    Google Scholar 

  27. 27.

    Ishihara T, Takeda T, Masuzaki H, Ohgiyama Y, Fukuhara K, Yano T, Yamaguchi G, Egawa H, Ohtsuka S, Okamura S, Kuwano K.Vibrio vulnificus isolated from blood culture. Eiseikensa 1984; 33 (Suppl.): 548. (in Japanese)

    Google Scholar 

  28. 28.

    Watanabe K, Sawatari K, Shigeno Y, Koga H, Nakazato H, Fukuda Y, Nagasawa M, Suzuyama Y, Yamaguchi K, Saito A, Hara K, Akatshi F, Ichimura N, Inoue M. A case report ofVibrio vulnificus with successful treatment. J J A Inf D 1984; 58: 239–245. (English Abst.)

    CAS  Google Scholar 

  29. 29.

    Kitagawa M, Tomura A, Fujishiro N, Kondo T, Nishiyama Y, Yoshi S. Two cases of Vibrio septicemia. J J A Inf D 1985; (Suppl.): 100. (in Japanese)

  30. 30.

    Ozaki K, Takano M, Koyanagi N, Kainuma Y, Yakata M, Kabasawa T. A case ofVibrio vulnificus septicemia. J J A Inf D 1986; 60 (Suppl.): 113. (in Japanese)

    Google Scholar 

  31. 31.

    Itoh H, Kaetsu M, Saeki Y, Tanaka S, Nagasawa Z, Nagumo F, Ueda H, Tadano J. A saved case of shock, DIC and necrotizing fascilitis associated withVibrio vulnificus sepsis. J J A Inf D 1985; 60: 695–699. (in Japanese)

    Google Scholar 

  32. 32.

    Shirouzu K, Miyamoto Y, Yasaka T, Matsubayashi Y, Morimatsu M.Vibrio vulnificus septicemia. Acta Pathol Jpn 1985; 35: 731–739.

    PubMed  CAS  Google Scholar 

  33. 33.

    Tanaka Y, Hirasawa M, Uzawa Y, Gomi K, Sato M, Takeuchi T, Terayama T. A case ofVibrio vulnificus septicemia. Eiseikensa 1986; 35 (Suppl.): 406. (in Japanese)

    Google Scholar 

  34. 34.

    Castillo LE, Winslow DL, Pankey GA. Wound infection and septic shock due toVibrio vulnificus. Am J Trop Med Hyg 1981; 30: 844–848.

    PubMed  CAS  Google Scholar 

  35. 35.

    Beckman EN, Leonard GL, Castillo LE, Gerne CF, Pankey GA. Histopathology of marine vibrio wound infections. Am J Clin Pathol 1981; 76: 765–772.

    PubMed  CAS  Google Scholar 

  36. 36.

    Howard RJ, Pessa ME, Brennaman BH, Ramphal R. Necrotizing soft tissue infections caused by marine Vibrios. Surgery 1985; 98: 126–130.

    PubMed  CAS  Google Scholar 

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Correspondence to Takashi Ohta MD.

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Ohta, T., Kato, R., Boku, K. et al. A case ofVibrio vulnificus infection. The Japanese Journal of Surgery 18, 580–587 (1988). https://doi.org/10.1007/BF02471493

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Key Words

  • Vibrio vulnificus
  • septicemia
  • DIC
  • cellulitis
  • liver cirrhosis