Abstract:

Objective To investigate the clinical features, treatment and prognosis of Vibrio vulnificus infection in patients with characteristic skin lesions. Methods Clinical data on 23 cases of Vibrio vulnificus infection with characteristic skin lesions collected from 1996 to 2008 in Second Affiliated Hospital Affiliated to Wenzhou Medical College, were analyzed retrospectively. Results There were 23 patients including 15 males and 8 females. Of them, 15 had a history of chronic type B viral hepatitis or alcoholic liver disease; 17 ate raw oysters before the onset. A rapid onset was observed in all of these patients, and initial symptoms were dominated by swelling and pain of, as well as bullae and hemorrhagic bulla in lower extremities. Vibrio vulnificus was isolated by culture from blister fluid of 13 patients, from both blood and blister fluid of 9 patients, and from necrotic tissue of 2 patients. Histopathologic examination revealed vacuolar degeneration and necrosis of cells, interstitial neutrophilic infiltrates, and vasculitis. Bacteria were seen in infiltrated neutrophiles. Electromicroscopy showed numerous round or arcuated microorganisms and bacterial flagella in hypodermal cells. Seven patients diagnosed from May 1996 to May 2000 died from this infection, and survival was observed after treatment only in 2 out of 6 patients collected from July 2000 to October 2003 and 6 out of 10 patients from May 2004 to October 2008. Conclusions Early recognition of skin eruptions and timely management are essential for the control of Vibrio vulnificus infection and for the improvement in survival among patients infected with this bacterium.

Key words: Vibrio vulnificus, skin lesions, prognosis