Vibrio vulnificus septicemia.

We report a case of Vibrio vulnificus infection in a middle-aged alcoholic man with Laennec's cirrhosis. The patient had recently received a puncture wound from the shell of a shrimp while fishing in the Gulf of Mexico. He presented with acrally distributed urticarial plaques, purpura, and bullae, as well as signs and symptoms of septic shock. Vibrio vulnificus was isolated from the blood, and histologic examination of the skin biopsy specimen demonstrated a devitalized, inflammatory, cell-poor superficial dermis and an acute cellulitis of the subcutis, with extensive tissue destruction. In addition, a necrotizing vasculitis, with a relative paucity of inflammatory cells but numerous bacilli around dermal vessels, was noted.