Vibrio Vulnificus skin infection

Cirrhosis w/recent consumption of raw oysters w/rapidly evolving rash. 

Vibrio vulnificus part of normal marine microbiota & causes illness in summer months temperate zones. All oysters at Chesapeake Bay have this organism, also 10% Crab, few cases post Hurricane Katrina. +gulf of Mexico Oyster consumption

First case of vibrio vulnificus maybe described by Hippocrates in 5 BC as foot cellulitis w/ black spots fatal in 48 hrs

Rapid onset of fever, chills, hypotension, rash progressing to hemorrhagic bullae to necrotic ulcers

Risk factors for vibrio vulnificus 🦪 🦀 sepsis: chronic liver disease, iron overload/hemochromatosis, hemolytic anemia, CKD, hiv, immunosuppressive meds, chronic alcoholics undergoing MOUD

Virulence: polysaccharide capsule which renders bacteria R to phagocytosis & directly stimulates inflammatory markers TNFα. Vibrio vulnificus can sequester iron from hemoglobin & 100% saturated transferrin

Early abx are critical: FQ, third gen cephalosporins & doxy are effective



Indiana University Infectious Diseases Fellowship @IUIDfellowship



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