Menier Lucie, Balandraud Alizée, Choufani Camille, Quere Pierre-Louis, Holay Quentin, Janvier Frédéric
Microbiology and Infection Control Unit, Military Instruction Hospital Sainte Anne, Toulon, France.
Orthopedic Surgery, Military Instruction Hospital Sainte Anne, Toulon, France.
Eur J Clin Microbiol Infect Dis. 2025 Aug;44(8):2013-2014. doi: 10.1007/s10096-025-05146-0. Epub 2025 Apr 30.
We describe in this article a case of a 55-year-old woman admitted to our hospital in France, for oedema and paraesthesia of the lower limbs after returning from a trip to Florida. In only four hours, the patient's condition evolved into a multiple organs failure, leading the physicians to carry out a TAP scan and a CT angiogram of the lower limb, which showed acute pan-colitis and diffuse infiltration of the skin and soft legs tissues. Leg fasciotomy was performed and revealed necrotizing fasciitis and myonecrosis. The evolution was unfavorable, leading to shock and death 12 h after hospital admission. Culture revealed Vibrio vulnificus and rapid genome sequencing led to identification of MO6-24/O genotype. V. vulnificus is a bacterium commonly found in warm coastal water and responsible for necrosis SSTI after exposure to seawater through skin lesions and gastroenteritis after ingestion of contaminated seafood. Strain MO6-24/O found in our patient is associated with very poor prognosis. This case is uncommon in Europe but the modification of geographic distribution due to warming coastal waters in Pacific and Atlantic coastal regions of the northern hemisphere lead to consider V. vulnificus in travellers from coastal and estuarine regions, with history of exposure to water or seafood consumption, especially during the summer.
我们在本文中描述了一例55岁女性的病例,该患者从佛罗里达旅行归来后因下肢水肿和感觉异常入住我们位于法国的医院。仅在四个小时内,患者的病情就发展为多器官功能衰竭,医生因此对其进行了下肢TAP扫描和CT血管造影,结果显示为急性全结肠炎以及皮肤和腿部软组织的弥漫性浸润。随后进行了腿部筋膜切开术,发现坏死性筋膜炎和肌坏死。病情发展不利,患者入院12小时后出现休克并死亡。培养结果显示为创伤弧菌,快速基因组测序鉴定出MO6-24/O基因型。创伤弧菌是一种常见于温暖沿海水域的细菌,通过皮肤损伤接触海水后可导致坏死性皮肤和软组织感染(SSTI),摄入受污染的海鲜后可引发肠胃炎。我们患者体内发现的MO6-24/O菌株与极差的预后相关。该病例在欧洲并不常见,但由于北半球太平洋和大西洋沿海地区沿海水域变暖导致地理分布发生变化,对于来自沿海和河口地区且有接触水或食用海鲜史的旅行者,尤其是在夏季,应考虑创伤弧菌感染。