Last reviewed: 28 Dec 2022
Last updated: 23 Feb 2022
Summary
Definition
History and exam
Key diagnostic factors
- leg pain
- cellulitis
- diarrhea
- abdominal cramps
- ear pain
- eye pain, redness
More key diagnostic factors
Other diagnostic factors
- fever
- altered mental status
- nausea
- vomiting
- hypotension
Other diagnostic factors
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)
More risk factors
Diagnostic investigations
1st investigations 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
More 1st investigations to order
Treatment algorithm
ACUTE
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
Christopher Huston, MD
Assistant Professor of Medicine
Division of Infectious Diseases
University of Vermont College of Medicine
Burlington
VT
Disclosures
CH 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.
Differentials
- Sepsis
- Gangrene
- Infectious diarrhea
More DifferentialsGuidelines
- Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021
- Vibrio species causing vibriosis
More GuidelinesPatient leaflets
Diarrhea in adults
Diarrhea in children
More Patient leafletsLog in or subscribe to access all of BMJ Best Practice
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