Summary
Definition
History and exam
Key diagnostic factors
- leg pain
- cellulitis
- diarrhea
- abdominal cramps
- ear pain
- eye pain, redness
Other diagnostic factors
- fever
- altered mental status
- nausea
- vomiting
- hypotension
Risk factors
- exposure to brackish or marine waters
- handling and/or cleaning seafood
- ingestion of raw or undercooked shellfish
- underlying hepatic disease (cirrhosis, hepatitis B or C, hemochromatosis)
- current corticosteroid use or other immunosuppression (HIV, chemotherapy, solid organ transplantation)
Diagnostic tests
1st tests to order
- complete blood count
- platelet count
- basic metabolic panel
- blood lactate
- blood culture
- wound swab for Gram stain
- wound swab for culture
- stool culture
- ear canal swab for culture
- conjunctival swab, corneal scraping, or chamber aspirates for culture
- culture-independent diagnostic testing (CIDT)
Treatment algorithm
sepsis or severe systemic infection
localized skin/soft-tissue infection alone
gastroenteritis
superficial inoculation infections
Contributors
Authors
Michael Sands, MD, MPH & TM, FIDSA

Professor of Medicine
College of Medicine
University of Florida
Jacksonville
FL
Disclosures
MS declares that he has no competing interests.
Carmen Isache, MD

Associate Professor of Medicine
College of Medicine
University of Florida
Jacksonville
FL
Disclosures
CI declares that she has no competing interests.
Peer reviewers
Larry Bush, MD, FACP, FIDSA
Affiliated Professor of Medicine
Charles E. Schmidt College of Medicine
Florida Atlantic University
Affiliated Associate Professor of Medicine
Department of Medical Education
University of Miami-Miller School of Medicine
FL
Disclosures
LB declares that he has no competing interests.
Franz Allerberger, MD, MPH
Professor of Clinical Microbiology
Austrian Agency for Health and Food Safety (AGES)
Vienna
Austria
Disclosures
FA declares that he has no competing interests.
References
Key articles
Dechet AM, Yu PA, Koram N, et al. Nonfoodborne Vibrio infections: an important cause of morbidity and mortality in the United States, 1997-2006. Clin Infect Dis. 2008;46:970-6. Abstract
California Department of Public Health. CDPH IDB guidance for managing select communicable diseases: non-cholera Vibrio infections. Jun 2023 [internet publication].Full text
Evans L, Rhodes A, Alhazzani W, et al. Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2021. Crit Care Med. 2021 Nov 1;49(11):e1063-143.Full text Abstract
Centers for Disease Control and Prevention. Vibrio species causing vibriosis. Information for health professionals and laboratorians. Aug 2023 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Sepsis
- Gangrene
- Infectious diarrhea
More DifferentialsGuidelines
- Non-cholera Vibrio infections
- Vibrio species causing vibriosis: information for health professionals & laboratorians
More GuidelinesPatient information
Diarrhea in adults
Diarrhea in children
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