Accurate diagnosis and treatment of Vibrio vulnificus infection: a retrospective study of 12 cases |
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Authors: | Yoshinori Matsuoka Yukishi Nakayama Tomoko Yamada Akira Nakagawachi Kouichi Matsumoto Kimihide Nakamura Kyousuke Sugiyama Yoshinori Tanigawa Yoshinobu Kakiuchi Yoshiro Sakaguchi |
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Affiliation: | 1. Department of Critical Care Medicine, Saga Medical School Hospital, Saga, Japan;2. Department of Anesthesiology and Intensive Care Medicine, Saga Medical School Hospital, Saga, Japan |
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Abstract: | Background and aimsVibrio 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.MethodsOver 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.ResultsThe 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%.ConclusionRecognition 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. |
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