1/16. Primary vibrio vulnificus bacteremia in a liver transplant recipient after ingestion of raw oysters: caveat emptor.vibrio vulnificus is responsible for severe infections in chronically ill patients. Organ transplant recipients are also at risk for severe infections due to V vulnificus. We report here the first case of V. vulnificus primary bacteremia due to raw shellfish consumption in a liver transplant recipient. All transplant patients should be cautioned against consuming uncooked seafood and warned about the risk of severe vibrio infections from seemingly innocuous wounds acquired in a salt water environment.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
2/16. A fatal case of vibrio vulnificus presenting as septic arthritis.vibrio vulnificus is an invasive gram-negative bacillus that may cause necrotizing cellulitis, bacteremia, and/or sepsis. Although V vulnificus infection is uncommon, it is frequently fatal and is usually attributed to ingestion of raw shellfish or traumatic exposure to a marine environment; patients are also often found to have a hepatic disorder (cirrhosis, alcohol abuse, or hemochromatosis) or an immunocompromised health status, and most commonly present with septicemia or a wound infection. We describe a patient who presented with septic arthritis as the first clinical manifestation of a V vulnificus infection. The organism was subsequently identified in a synovial fluid aspirate.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
3/16. Experience of six patients with vibrio vulnificus septicemia.vibrio vulnificus, a halophilic lactose fermenting vibrio, is a virulent pathogen for men and is frequently associated with overwhelming infections of areas other than the gastrointestinal tract. We encountered six cases of vibrio vulnificus septicemia in veterans General Hospital-Taipei over the past four years. All were admitted through the emergency room and presented with urgent conditions on arrival. The patients also demonstrated preexisting liver function impairment (either hepatic disease or chronic alcohol consumption). Five subjects had an apparent history of exposure to marine environments: one fisherman with pre-existing wounds and four others with previous consumption of poorly cooked seafood. Characteristic hemorrhagic bullous lesions were found in 5 cases. In all, 4 patients (67%) died with three of the cases within 24 hours of hospitalization. Misdiagnosis and delayed treatment were the most common causes. In conclusion, when patients present with sepsis and/or characteristic cutaneous lesions, particulously those with underlying liver disease and a history of marine exposure, clinicians should be alerted to this potentially fatal infection and should commence appropriate assessment and treatment immediately.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
4/16. Varied clinical presentations of vibrio vulnificus infections: a report of four unusual cases and review of the literature.vibrio vulnificus is a Gram-negative, motile, curved bacillus of the family vibrionaceae that is a rare cause of gastroenteritis, septicemia, and wound infections in humans. V. vulnificus is halophilic, flourishes in warm temperatures, and is part of the bacterial flora of the marine environment. The location of our health care setting, on the gulf of mexico, has given us the opportunity to observe a wide variety of clinical presentations of infections caused by this organism. In the first case, a 27-year-old man struck by lightning while windsurfing was found pulseless in the water and was resuscitated. The patient subsequently developed cardiac arrhythmias, respiratory failure, and necrotizing fasciitis, blood cultures yielded V. vulnificus. After antibiotic therapy and several fasciotomies, the patient recovered. The second case was that of a 43-year-old Asian man employed as an oyster shucker who presented with complaints of redness, tearing, and photophobia of the right eye. The diagnosis of corneal ulcer secondary to V. vulnificus was made after culture of the right eye revealed the organism. The third case involved a 46-year-old man who presented with complaints of abdominal pain, nausea, chills, and bullous lesions on the lower extremities. He developed disseminated intravascular coagulation, and cultures of the lesions on his lower extremities showed V. vulnificus. Initially, the patient denied any exposure to raw seafood or seawater, but he eventually remembered eating raw oysters 3 days before his illness. The fourth case is that of a 32-year-old, human immunodeficiency virus-positive, hepatitis c-positive woman with cirrhosis who presented with productive cough, chills, fever, and red spots on her extremities and buttocks. blood cultures revealed V. vulnificus and the patient was treated with antibiotics and improved clinically. These four cases illustrate the wide range of clinical presentations associated with this organism.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
5/16. Hand infections caused by delayed inoculation of vibrio vulnificus: does human skin serve as a potential reservoir of vibrios?vibrio vulnificus may cause severe soft tissue infections of the upper extremity. This pathogen usually gains access to soft tissues either by direct inoculation through a penetrating injury by an infected marine animal or by exposing abraded skin to contaminated water. We report five patients with vibrio vulnificus hand infections following superficial hand injuries incurred within 24 hours after uneventful handling of fish. This clinical observation, together with the fact that the physiologic characteristics of human sweat simulate the natural environment of the vibrio vulnificus, support the assumption that human skin may serve as a reservoir for Vibrios. The anamnesis in patients presenting with hand infection should essentially include an inquiry regarding recent, albeit uneventful, fish handling.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
6/16. Vibrio illnesses after Hurricane Katrina--multiple states, August-September 2005.Hurricane Katrina made landfall on August 29, 2005, with major impact on the U.S. Gulf Coast. During August 29-September 11, surveillance identified 22 new cases of Vibrio illness with five deaths in persons who had resided in two states. These illnesses were caused by V. vulnificus, V. parahaemolyticus, and nontoxigenic V. cholerae. These organisms are acquired from the environment and are unlikely to cause outbreaks from person-to-person transmission. No cases of toxigenic V. cholerae serogroups O1 or O139, the causative agents of cholera, were identified. This report summarizes the investigation by state and local health departments and CDC, describes three illustrative cases, and provides background information on Vibrio illnesses. Results of the investigation underscore the need for heightened clinical awareness, appropriate culturing of specimens from patients, and empiric treatment of illnesses (particularly those associated with wound infections) caused by Vibrio species. No confirmed cases of illness have been identified with onset after September 5; additional Vibrio cases are under investigation.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
7/16. Isolation of Protomonas extorquens (the 'red phantom') from a patient with AIDS.We report the isolation of a pigmented, slowly growing, environmental organism with pink colonies from the blood of a patient with AIDS. The organism was characterised biochemically and by protein 'fingerprinting' as Protomonas extorquens biovar 3. This is the first report of isolation of this organism from a patient with AIDS.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
8/16. Vibrio sepsis in a cirrhotic patient.vibrio vulnificus should be suspected in any soft tissue infection occurring after exposure to the marine environment. Early recognition followed by appropriate antibiotic therapy and debridement of involved tissue are essential features in the treatment of these infections.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
9/16. Vibrio hand infections: a case report and review of the literature.A case of vibrio vulnificus infection of the hand is presented. The role of Vibrio species as primary pathogens in infections associated with exposure to a marine environment is discussed.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
10/16. vibrio vulnificus infection. Case report and update since 1970.vibrio vulnificus infections is being reported with increasing frequency in coastal regions of the united states. Raw seafood consumption, particularly raw oysters, and wounds acquired in a marine environment predispose to infection. patients with advanced liver disease are at increased risk of developing septicemia. V. vulnificus is a virulent pathogen producing significant morbidity and mortality; its virulence relates in part to the production of exotoxin. skin lesions occur early in the clinical course of infection and provide means of specific diagnosis. The patient and the consulting physician are well served by the dermatologist capable of recognizing this infectious disease.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
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