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Septicaemia secondary to Vibrio vulnificus

Abstract number: 1733_459

Villamil-Cajoto I., Rodriguez-Otero L., Cortizo S., Garcia-Zabarte M.A., Aguilera-Guirao A., Treviño-Castellano M.

Introduction:Vibrio vulnificus is a halophilic species which has demonstrated its pathogenic power by causing septicaemia and bacteraemia in patients who had ingested contaminated seafood (especially raw oysters) and infections of soft tissues exposed to sea water. The mortality rate in the case of septicaemia can reach values higher than 50%. Hepatic diseases and inmunodepression are the main risk factors.

Clinical case: A 37 years old male arrives at the emergency service of the hospital because of a temperature of 38.4°C, local pain and a one week old inflammation in the right lower limb. Physical examination revealed an oedematous and erithematous infected wound in the external malleolar region of the right lower limb which was caused by a sharp vegetal object and which got considerably worse after swimming in the sea. The hemogramme showed 18.500 neutrophilic leukocytes (91%). VHS 72 mm. Coagulation tests revealed a protrombine time of 33%, INR of 2.6, fibrinogen level of 585 mg/dl and an activated partial thromboplastin time of 43 seconds. The patient was diagnosed with cellulitis and lymphangitis in the right lower limb. The molecular analysis of the HFE gen revealed a heterozygosis of the C282Y mutation. Six days after the admission to hospital the blood cultures became positive. The biochemical identification of the colony was realised by the API 20 NE system (bioMérieux, Marcy l'Etoile, France).

The result obtained showed the numeric code 7–6-3–0-0–4-4 which could be identified as Vibrio vulnificus with a T-value of 0.51. The isolated strain was resistant to ampicillin and amoxicillin-clavulanic and sensitive to third and fourth-generation cephalosporins, monobactams, carbapenems, tetracycline, cotrimoxazole, and fluorquinolones. On the 10th hospital day and after a favourable clinical progress the patient was discharged.

Conclusions:Vibrio vulnificus shows high affinity for iron, which can explain its connection to diseases with increased iron deposit, such as chronic liver problems caused by hemochromatosis. Our group describes the second case exposed in scientific literature of a patient whose biochemical markers for iron metabolism show normal values and who is carrier of heterozygosis of the C282Y mutation in the HFE gen of the hemochromatosis.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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