C Metelmann1, B Metelmann1, M Gründling2, K Hahnenkamp1, G Hauk3, C Scheer1. 1. Klinik für Anästhesiologie, Anästhesie, Intensiv‑, Notfall- und Schmerzmedizin, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland. 2. Klinik für Anästhesiologie, Anästhesie, Intensiv‑, Notfall- und Schmerzmedizin, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland. Matthias.Gruendling@med.uni-greifswald.de. 3. Abteilung 3, Dezernat Umwelthygiene, Umweltmedizin, Landesamt für Gesundheit und Soziales Mecklenburg-Vorpommern, Gertrudenstraße 11, 18057, Rostock, Deutschland.
Abstract
BACKGROUND: The prevalence of Vibrio vulnificus heavily depends on the temperature and salinity of the sea water. In the course of climate change an increase in cases of fatal sepsis caused by V. vulnificus at the German Baltic Sea coast could be detected. OBJECTIVE: To generate awareness for a life-threatening infection with increasing incidence in Germany. MATERIAL AND METHODS: This article presents an overview of the current state of the literature followed by an exemplary description of cases with V vulnificus sepsis caused by contact with water in the Baltic Sea, which were treated at the Medical University in Greifswald in summer 2018. RESULTS: In the presence of risk factors, such as liver and kidney diseases, immunosuppression and male sex, there is a danger of severe sepsis if damaged skin comes into contact with contaminated sea water. A pronounced organ dysfunction can frequently be found on admission. In these cases the diagnosis must be made promptly and timely surgical cleansing and antibiotic treatment should be initiated (e.g. a combination of tetracyclines and third generation cephalosporins). CONCLUSION: Sepsis due to V. vulnificus will probably increase over the coming years. Because there is a latency in some cases between infection and onset of sepsis, physicians beyond the coastal region must also be informed about this disease.
BACKGROUND: The prevalence of Vibrio vulnificus heavily depends on the temperature and salinity of the sea water. In the course of climate change an increase in cases of fatal sepsis caused by V. vulnificus at the German Baltic Sea coast could be detected. OBJECTIVE: To generate awareness for a life-threatening infection with increasing incidence in Germany. MATERIAL AND METHODS: This article presents an overview of the current state of the literature followed by an exemplary description of cases with V vulnificus sepsis caused by contact with water in the Baltic Sea, which were treated at the Medical University in Greifswald in summer 2018. RESULTS: In the presence of risk factors, such as liver and kidney diseases, immunosuppression and male sex, there is a danger of severe sepsis if damaged skin comes into contact with contaminated sea water. A pronounced organ dysfunction can frequently be found on admission. In these cases the diagnosis must be made promptly and timely surgical cleansing and antibiotic treatment should be initiated (e.g. a combination of tetracyclines and third generation cephalosporins). CONCLUSION:Sepsis due to V. vulnificus will probably increase over the coming years. Because there is a latency in some cases between infection and onset of sepsis, physicians beyond the coastal region must also be informed about this disease.
Entities:
Keywords:
Case of emergency; Climate change; Immunosuppression; Sepsis; Wound infection
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