Archive for February 17, 2017

Vibrio vulnificus DNA load and mortality.

J Clin Microbiol. 2011 Jan;49(1):413-5.

Kim DM1, Jung SI, Jang HC, Lee CS, Lee SH, Yun NR, Neupane GP, Park KH.

Author information

1Division of Infectious Disease, Department of Internal Medicine, School of Medicine, Chosun University, Gwang-ju, South Korea.

Abstract

We determined the association between DNA load and mortality in patients with Vibrio vulnificus infection. Real-time PCR performed on sera of 27 culture-positive patients showed a significantly higher median DNA load in nonsurvivors than in survivors. Hence, real-time PCR can be used as an early prognostic factor in V. vulnificus septicemia.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3020430/pdf/1913-09.pdf

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February 17, 2017 at 4:42 pm

Accurate diagnosis and treatment of Vibrio vulnificus infection: a retrospective study of 12 cases.

Braz J Infect Dis. 2013 Jan-Feb;17(1):7-12.

Matsuoka Y1, Nakayama Y, Yamada T, Nakagawachi A, Matsumoto K, Nakamura K, Sugiyama K, Tanigawa Y, Kakiuchi  Y, Sakaguchi Y.

Author information

1Department of Critical Care Medicine, Saga Medical School Hospital, Saga, Japan. yoshinori216@h2.dion.ne.jp

Abstract

BACKGROUND AND AIMS:

Vibrio vulnificus causes an infectious disease that has extremely poor convalescence and leads to necrotic fasciitis. In this study, we sought to define the characteristic epidemiology of V. vulnificus infection and clarify its diagnosis at the global level.

METHODS:

Over a period of 10 years, we investigated the appearance of symptoms, underlying conditions, treatment, and mortality in 12 patients (eight men, four women; >50 years old; average age, 66 years,) infected with V. vulnificus.

RESULTS:

The development of symptoms occurred primarily between June and September, a period during which seawater temperature rises and the prevalence of V. vulnificus increases. All patients had underlying diseases, and seven patients reported a history of consuming fresh fish and uncooked shellfish. The patients developed sepsis and fever with sharp pain in the limbs. Limb abnormalities were observed on visual examination. All patients underwent debridement; however, in the survival group, the involved limb was amputated early in 80% patients. The mortality rate was 58.3%.

CONCLUSION:

Recognition of the characteristic epidemiology and clinical features of this disease is important, and positive debridement should be performed on suspicion. When the illness reaches an advanced stage, however, amputation should be the immediate treatment of choice.

FULL TEXT (and PDF)

http://www.sciencedirect.com/science/article/pii/S141386701200219X

February 17, 2017 at 4:41 pm

Pre-existing medical conditions associated with Vibrio vulnificus septicaemia.

Epidemiol Infect. 2014 Apr;142(4):878-81.

Menon MP1, Yu PA1, Iwamoto M1, Painter J1.

Author information

1Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.

Abstract

Vibrio vulnificus (Vv) can result in severe disease. Although pre-existing liver disease is a recognized risk factor for serious infection, the relative importance of other comorbidities has not been fully assessed.

We analysed reports of Vv infections submitted to CDC from January 1988 to September 2006 in order to assess the role of pre-existing conditions contributing to severe outcomes.

A total of 1212 patients with Vv infection were reported. Only patients with liver disease [adjusted odds ratio (aOR) 5.1)] were more likely to become septic when exposure was due to contaminated food.

Patients with liver disease (aOR 4.1), a haematological disease (aOR 3.2), or malignancy (aOR 3.2) were more likely to become septic when infection was acquired via a non-foodborne exposure.

As such, patients with these pre-existing medical conditions should be advised of the risk of life-threatening illness after eating undercooked contaminated seafood or exposing broken skin to warm seawater

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4598054/pdf/nihms727972.pdf

February 17, 2017 at 4:39 pm

Severe septicemia, necrotizing fasciitis, and peritonitis due to Vibrio vulnificus in a patient undergoing continuous ambulatory peritoneal dialysis: a case report.

BMC Infect Dis. 2015 Oct 14;15:422.

Kim CS1, Bae EH2, Ma SK3, Kim SW4.

Author information

1Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju, 501-757, South Korea. laminion@hanmail.net

2Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju, 501-757, South Korea. baedak@hanmail.net

3Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju, 501-757, South Korea. drmsk@hanmail.net

4Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju, 501-757, South Korea. skimw@chonnam.ac.kr .

Abstract

BACKGROUND:

Chronic kidney disease, including end-stage renal disease, has been identified as a possible risk factor for primary septicemia and wound infection by Vibrio vulnificus. However, cases of severe septicemia, necrotizing fasciitis, and peritonitis caused by V. vulnificus in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) have not been described. We report a case of severe septicemia, necrotizing fasciitis, and peritonitis due to V. vulnificus in a patient undergoing CAPD after ingesting raw seafood.

CASE PRESENTATION:

A 37-year-old woman undergoing CAPD was admitted to the emergency room due to general weakness, fever, diarrhea, and abdominal pain. Although empirical intraperitoneal antibiotics were administered for the diagnosis of CAPD-related peritonitis, her fever did not subside. On hospital day 3, she had hemorrhagic bullae on both lower legs. We evaluated her recent food history, and found that she ate raw seafood before admission. She underwent emergency fasciotomy on the suspicion of necrotizing fasciitis by V. vulnificus infection. Finally, V. vulnificus was confirmed by 16S ribosomal ribonucleic acid gene sequencing using blood and peritoneal effluent fluid cultures. The administration of intraperitoneal ceftazidime and intravenous ciprofloxacin/ceftriaxone was continued for 4 weeks, and the patient completely recovered.

CONCLUSIONS:

Suspicion of V. vulnificus infection in vulnerable patients who ingest raw seafood is essential for prompt diagnosis, which could significantly improve patient outcomes.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606901/pdf/12879_2015_Article_1163.pdf

February 17, 2017 at 4:36 pm


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