Vibrio Vulnificus skin infection Cirrhosis w/recent consumption of raw oysters w/rapidly evolving rash. Vibrio vulnificus part of normal marine microbiota & causes illness in summer months temperate zones. All oysters at Chesapeake Bay have this organism, also 10% Crab, few cases post Hurricane Katrina. +gulf of Mexico Oyster consumption First case of vibrio vulnificus maybe described by Hippocrates in 5 BC as foot cellulitis w/ black spots fatal in 48 hrs Rapid onset of fever, chills, hypotension, rash progressing to hemorrhagic bullae to necrotic ulcers Risk factors for vibrio vulnificus 🦪 🦀 sepsis: chronic liver disease, iron overload/hemochromatosis, hemolytic anemia, CKD, hiv, immunosuppressive meds, chronic alcoholics undergoing MOUD Virulence: polysaccharide capsule which renders bacteria R to phagocytosis & directly stimulates inflammatory markers TNFα. Vibrio vulnificus can sequester iron from hemoglobin & 100% saturated transferrin Early abx are critical: FQ, third gen cephalosporins & doxy are effective Indiana University Infectious Diseases Fellowship @IUIDfellowship #Vibrio #Vulnificus #skin #infection #rash #cellulitis #dermatology #legs #clinical #photo
