Vibrio vulnificus is the most virulent and can rapidly produce fatal septic shock in immunocompromised patients or those with underlying liver disease.
The diagnosis is based on blood, wound, and/or stool cultures.
Treatment consists of intravenous antibiotic therapy with two agents for those with sepsis or severe systemic infection. Patients with necrotizing skin/soft-tissue infection also require early aggressive debridement of the infected tissue. Localized skin/soft-tissue wound infections are managed with oral antibiotics and close observation.
Gastroenteritis syndromes are treated with rehydration. Oral antibiotics are indicated if diarrhea persists >5 days.
Prognosis varies with the host's underlying comorbidity and the clinical presentation of the infection.
Non-cholera Vibrio infections are infections caused by Vibrio species other than V cholerae. Vibrio infections are most often associated with consumption of raw or undercooked shellfish, or traumatic exposure to sea or brackish water. They are characterized by diarrhea and vomiting, sepsis, and/or skin/soft-tissue infections.
History and exam
Key diagnostic factors
- leg pain
- abdominal cramps
- ear pain
- eye pain, redness
Other diagnostic factors
- altered mental status
- 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)
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
sepsis or severe systemic infection
localized skin/soft-tissue infection alone
superficial inoculation infections
- Infectious diarrhea
- Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021
- Vibrio species causing vibriosis
Diarrhea in adults
Diarrhea in childrenMore Patient leaflets
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