Klontz K C, Lieb S, Schreiber M, Janowski H T, Baldy L M, Gunn R A
Centers for Disease Control, Atlanta, Georgia.
Ann Intern Med. 1988 Aug 15;109(4):318-23. doi: 10.7326/0003-4819-109-4-318.
To describe the clinical and epidemiologic features of Vibrio vulnificus infections.
Case series based on notifiable disease report forms and patient medical records.
Cases reported to the Florida Department of Health and Rehabilitative Services from 1981 to 1987.
Sixty-two patients with V. vulnificus infection.
The three clinical syndromes found were primary septicemia (38 patients), wound infections (17 patients), and gastrointestinal illness without septicemia or wound infections (7 patients). Mortality rate was highest for patients with primary septicemia (55%; 95% CI, 38 to 71) and intermediate for wound infections (24%; 95% CI, 8 to 51): no deaths occurred in those with gastrointestinal illness. Common characteristics and exposures in patients with these syndromes included recent history of raw oyster consumption for primary septicemia and gastrointestinal illness, liver disease for primary septicemia, and either having a preexisting wound or sustaining a wound in contact with seawater for wound infections.
Clinicians should ask about marine exposures in patients with underlying medical conditions, especially liver disease, who present with unexplained febrile illness, and should start appropriate therapy promptly.
描述创伤弧菌感染的临床和流行病学特征。
基于法定传染病报告表和患者病历的病例系列研究。
1981年至1987年向佛罗里达州卫生与康复服务部报告的病例。
62例创伤弧菌感染患者。
发现三种临床综合征，即原发性败血症（38例患者）、伤口感染（17例患者）和无败血症或伤口感染的胃肠道疾病（7例患者）。原发性败血症患者的死亡率最高（55%；95%可信区间，38%至71%），伤口感染患者的死亡率居中（24%；95%可信区间，8%至51%）：胃肠道疾病患者无死亡病例。这些综合征患者的共同特征和暴露因素包括原发性败血症和胃肠道疾病患者近期有食用生牡蛎史、原发性败血症患者有肝病，以及伤口感染患者有既往伤口或有与海水接触的伤口。
临床医生应对有基础疾病（尤其是肝病）且出现不明原因发热性疾病的患者询问海洋暴露史，并应及时开始适当治疗。
