Vibrio vulnificus
Scanning electron microscope image of Vibrio vulnificus
Vibrio vulnificus is a species of gram-negative, curved rod bacteria of the genus Vibrio. They occur in marine environments such as estuaries, brackish water ponds or coastal areas. V. vulnificus is closely related to V. cholerae, the cause of the cholera, Infection with V. vulnificus resulting in rapidly expanding cellulitis or sepsis. . 279
Clinical Features
Vibrio vulnificus causes an infection that often after eating seafood, especially oysters, occurs; the bacteria can also through open wounds penetrate the body while swimming or wading in infested waters, or stab wounds by thorns of fish such as the tilapia. Symptoms include vomiting, diarrhea, abdominal pain and blisters throwing dermatitis, which is sometimes mistaken for pemphigus vulgaris or pemphigus.
In people with weakened immune systems such as chronic liver disease is an infected with Vibrio bacteria can quickly worsen section and spread to the bloodstream. Severe symptoms may occur, even death.
Treatment
Vibrio vulnificus infections have a mortality of about 25%. However, when the infection develops into a sepsis, the mortality rate increases to up to 50%, with most patients dying during the first 48 hours of infection. The optimal treatment is not known, but a retrospective study of 93 patients in Taiwan showed that the application of a cephalosporin of the third generation tetracyclines (eg, ceftriaxone or doxycycline) is associated with a better treatment outcome. Prospective clinical studies need to confirm this discovery yet, but in vitro data support the assumption that this combination against Vibrio vulnificus acts synergistically.
Vibrio vulnificus often causes large, disfiguring tumors, the major surgery ( debridement ), or even amputations require.
Forecast
The worst prognosis those patients who reach the hospital in shock. The overall mortality of treated patients is 33%.
Patients who are particularly vulnerable, including those with immunodeficiency (cancer, bone marrow suppression, HIV, diabetes, etc.). In these cases, V. vulnificus usually arrives in the bloodstream, where it can cause fever and chills, septic shock ( with drastically reduced blood pressure) and bubble- throwing skin lesions. The Centers for Disease Control and Prevention According kills about half of those who have suffered a blood infection.
Vibrio vulnificus infections with concern often than the average men; 85 % of those who suffer a endotoxinschen shock caused by the bacteria, are male. Women with oophorectomy have increased mortality, probably because estrogen protects against V. vulnificus acts.
Occurrence
In people who have been evacuated because of the flooding after Hurricane Katrina in New Orleans, health officials strains of V. vulnificus infections have clearly identified. The German Baltic Sea coast is according to a study due to the low salinity and strong heating of the most vulnerable areas.