Ms. Coerdt is from the Georgetown University School of Medicine, Washington, District of Columbia. Dr. Khachemoune is from the Department of Dermatology, SUNY Downstate, Brooklyn, and the Department of Dermatology, Brooklyn Campus of the VA NY Harbor Healthcare System.
Cutis. 2021 Feb;107(2):E12-E17. doi: 10.12788/cutis.0183.
Vibrio vulnificus is a motile, gram-negative, halophilic, aquatic bacterium that is part of the normal estuarine microbiome and typically is found in warm coastal waters. Infection with the pathogen typically is due to consumption of contaminated seafood or exposure to contaminated seawater. Vibrio vulnificus has a mortality rate of almost 33% in the United States and is responsible for more than 95% of seafood-related deaths in the United States. Vibrio vulnificus can cause a vast spectrum of diseases, such as gastroenteritis, cellulitis, necrotizing fasciitis, and sepsis. Gastroenteritis is self-limited, whereas septicemia often is fatal. Gastroenteritis and septicemia are caused by ingestion of contaminated shellfish, whereas wound infections and necrotizing fasciitis are caused by exposure to contaminated seawater or handling of contaminated seafood. Septicemia is the most common presentation of V vulnificus and accounts for the most fatalities from the bacteria. Prompt diagnosis and treatment are vital to prevent mortality. It is important to keep V vulnificus on the differential when a patient presents with bullae or cellulitis or has a history of raw seafood consumption or exposure to brackish water, as missing the diagnosis could lead to necrotizing fasciitis, sepsis, and death.
创伤弧菌是一种运动的、革兰氏阴性、嗜盐的水生细菌，是正常港湾微生物组的一部分，通常存在于温暖的沿海水域。病原体感染通常是由于食用受污染的海鲜或接触受污染的海水。在美国，创伤弧菌的死亡率接近 33%，是美国与海鲜相关死亡的 95%以上的原因。创伤弧菌可引起广泛的疾病，如肠胃炎、蜂窝织炎、坏死性筋膜炎和败血症。肠胃炎是自限性的，而败血症通常是致命的。肠胃炎和败血症是由于摄入受污染的贝类引起的，而伤口感染和坏死性筋膜炎是由于接触受污染的海水或处理受污染的海鲜引起的。败血症是创伤弧菌最常见的表现，也是该细菌导致死亡最多的原因。及时诊断和治疗对于预防死亡率至关重要。当患者出现水疱或蜂窝织炎，或有生食海鲜史或接触微咸水史时，应注意鉴别诊断创伤弧菌，因为漏诊可能导致坏死性筋膜炎、败血症和死亡。
