Experience of six patients with Vibrio vulnificus septicemia.

Vibrio vulnificus, a halophilic lactose fermenting vibrio, is a virulent pathogen for men and is frequently associated with overwhelming infections of areas other than the gastrointestinal tract. We encountered six cases of Vibrio vulnificus septicemia in Veterans General Hospital-Taipei over the past four years. All were admitted through the emergency room and presented with urgent conditions on arrival. The patients also demonstrated preexisting liver function impairment (either hepatic disease or chronic alcohol consumption). Five subjects had an apparent history of exposure to marine environments: one fisherman with pre-existing wounds and four others with previous consumption of poorly cooked seafood. Characteristic hemorrhagic bullous lesions were found in 5 cases. In all, 4 patients (67%) died with three of the cases within 24 hours of hospitalization. Misdiagnosis and delayed treatment were the most common causes. In conclusion, when patients present with sepsis and/or characteristic cutaneous lesions, particulously those with underlying liver disease and a history of marine exposure, clinicians should be alerted to this potentially fatal infection and should commence appropriate assessment and treatment immediately.