vibrio vulnificus can be fatal in liver disease patients


This patient’s presentation is consistent with Vibrio vulnificus infection, a gram-negative bacterium that causes serious wound infections and sepsis.  The organism is most virulent in patients with cirrhosis, hemochromatosis, and chronic diseases (e.g., diabetes mellitus, chronic kidney disease, hepatitis).  Vibrio vulnificus is associated with undercooked or raw shellfish, especially raw oysters.  Since the infection can be fatal, high-risk patients should avoid eating, or even handling, raw shellfish.

Patients typically present with wound infections, sepsis without a clearly defined infectious source, and/or gastroenteritis with characteristic bullous skin lesions.  Diagnosis is confirmed with culture (wound, stool, blood), and suspected patients should receive immediate antibiotics (e.g., tetracycline) with close ICU monitoring.  Patients can rapidly decompensate (within 12 hours) and develop bullous lesions, DIC, and even death.

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