Vibrio vulnificus: Difference between revisions
From IDWiki
Vibrio vulnificus
m (Aidan moved page Vibrio vulnificans to Vibrio vulnificus without leaving a redirect: oops) |
No edit summary |
||
| Line 1: | Line 1: | ||
* Halophilic (salt-loving) marine pleomorphic Gram-negative rod that causes severe rapidly-progressing soft tissue infections |
* Halophilic (salt-loving) marine pleomorphic Gram-negative rod that causes severe rapidly-progressing soft tissue infections |
||
| + | ==Background== |
||
| − | == |
+ | ===Pathophysiology=== |
| − | |||
* Polysaccharide capsule is resistant to phagocytosis and triggers cytokine release including TNF-alpha |
* Polysaccharide capsule is resistant to phagocytosis and triggers cytokine release including TNF-alpha |
||
* It can sequester iron from hemoglobin and highly-saturated transferrin |
* It can sequester iron from hemoglobin and highly-saturated transferrin |
||
| − | == |
+ | ===Epidemiology=== |
| − | |||
* Mostly found in saltwater estuaries, associated with springtime plankton blooms |
* Mostly found in saltwater estuaries, associated with springtime plankton blooms |
||
* Normal microbiotia of molluscs, including oysters and crabs |
* Normal microbiotia of molluscs, including oysters and crabs |
||
| − | == |
+ | ===Risk Factors=== |
| − | |||
* Cirrhosis |
* Cirrhosis |
||
* Other liver disease |
* Other liver disease |
||
| Line 20: | Line 18: | ||
* Immunosuppressing medications |
* Immunosuppressing medications |
||
| − | == Presentation |
+ | ==Clinical Presentation== |
| − | |||
* Presents as sepsis and skin infection in an immunocompromised patient (usually cirrhosis) 1 to 3 days following ingestion of ulcers |
* Presents as sepsis and skin infection in an immunocompromised patient (usually cirrhosis) 1 to 3 days following ingestion of ulcers |
||
* Severe, rapidly-progressing soft tissue infection |
* Severe, rapidly-progressing soft tissue infection |
||
| Line 31: | Line 28: | ||
* 25% case-fatality rate, up to 50% in cases of bacteremia |
* 25% case-fatality rate, up to 50% in cases of bacteremia |
||
| − | == |
+ | ==Management== |
| − | |||
* Needs antibiotics, ideally early, as well as surgical debridement of the nectrotizing soft tissue infection |
* Needs antibiotics, ideally early, as well as surgical debridement of the nectrotizing soft tissue infection |
||
* Fluoroquinolones, third-gen cephalosporins, and doxycycline all work |
* Fluoroquinolones, third-gen cephalosporins, and doxycycline all work |
||
| − | == |
+ | ==Prevention== |
| − | |||
* Patients with cirrhosis should avoid eating raw oysters |
* Patients with cirrhosis should avoid eating raw oysters |
||
| − | {{DISPLAYTITLE:''Vibrio |
+ | {{DISPLAYTITLE:''Vibrio vulnificus''}} |
[[Category:Gram-negative bacilli]] |
[[Category:Gram-negative bacilli]] |
||
Revision as of 22:16, 16 June 2020
- Halophilic (salt-loving) marine pleomorphic Gram-negative rod that causes severe rapidly-progressing soft tissue infections
Background
Pathophysiology
- Polysaccharide capsule is resistant to phagocytosis and triggers cytokine release including TNF-alpha
- It can sequester iron from hemoglobin and highly-saturated transferrin
Epidemiology
- Mostly found in saltwater estuaries, associated with springtime plankton blooms
- Normal microbiotia of molluscs, including oysters and crabs
Risk Factors
- Cirrhosis
- Other liver disease
- Iron-overload states including hemochromatosis, hemolytic anemia, chronic renal failure
- Malignancy
- HIV
- Immunosuppressing medications
Clinical Presentation
- Presents as sepsis and skin infection in an immunocompromised patient (usually cirrhosis) 1 to 3 days following ingestion of ulcers
- Severe, rapidly-progressing soft tissue infection
- Erythematous lesions that develop into hemorrhagic bullae then necrotic ulcers
- Metastatic cutaneous lesions develop at 36 hours
- Often related to a wound contaminated with salt water, often in the Golf Coast
- Bacteremia is common
- Associated with oyster consumption in 90% of cases
- 25% case-fatality rate, up to 50% in cases of bacteremia
Management
- Needs antibiotics, ideally early, as well as surgical debridement of the nectrotizing soft tissue infection
- Fluoroquinolones, third-gen cephalosporins, and doxycycline all work
Prevention
- Patients with cirrhosis should avoid eating raw oysters
