Vibrio vulnificus - Revision history

Elcatracho: /* Clinical Features */

2021-01-15T02:54:19Z

Clinical Features

← Older revision		Revision as of 02:54, 15 January 2021
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	**[[Vomiting]], [[diarrhea]], and/or [[abdominal pain]]		**[[Vomiting]], [[diarrhea]], and/or [[abdominal pain]]
	**+/- [[fever]], chills, or [[septic shock]]<ref>Choi HJ, Lee DK, Lee MW, Choi JH, Moon KC, Koh JK. Vibrio vulnificus septicemia presenting as purpura fulminans. J Dermatol. Jan 2005;32(1):48-51.</ref>		**+/- [[fever]], chills, or [[septic shock]]<ref>Choi HJ, Lee DK, Lee MW, Choi JH, Moon KC, Koh JK. Vibrio vulnificus septicemia presenting as purpura fulminans. J Dermatol. Jan 2005;32(1):48-51.</ref>
			**Primary septicemia associated with highest case fatality rate among all foodborne infections (39%)<ref>Mead PS, Slutsker L, Dietz V, et al. Food-related illness and death in the United States. Emerg Infect Dis. 1999;5(5):607-625. doi:10.3201/eid0505.990502</ref>

	==Differential Diagnosis==		==Differential Diagnosis==

ClaireLewis at 17:09, 28 August 2019

2019-08-28T17:09:26Z

← Older revision		Revision as of 17:09, 28 August 2019
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	==Background==		==Background==
	*~~History of handling or ingestion of raw seafood (most commonly oysters)~~		*Gram negative bacterium living in marine environments
	**Handling: rapid cellulitis that progresses to hemorrhagic bullae and purpura fulminans		*Leading cause of shellfish-associated death in US
	**Ingestion: vomiting, diarrhea, or abdominal pain, and may present with fever, chills, or shock
	**Patients with [[cirrhosis]] at high risk		**Patients with [[cirrhosis]] at high risk
	*Severe Complications<ref>Choi HJ, Lee DK, Lee MW, Choi JH, Moon KC, Koh JK. Vibrio vulnificus septicemia presenting as purpura fulminans. J Dermatol. Jan 2005;32(1):48-51.</ref>
	**Necrotizing fasciitis and septicemia
	**Immediate and intensive empirical antibiotic treatment
	**Surgical debridement in suspected cases

	{{Vibrio species}}		{{Vibrio species}}

	~~==Background==~~
	*Gram negative bacterium living in marine environments
	*Leading cause of shellfish-associated death in US

	==Clinical Features==		==Clinical Features==
	*~~Fever~~, ~~septic shock, bullous~~ skin ~~lesions~~
	*Wound infections can spread rapidly causing severe myositis and necrotizing fasciitis		*History of handling or ingestion of raw/undercooked seafood (most commonly oysters), exposure to marine/estuarine water
	*~~More commonly seen in high risk patients~~: ~~liver disease~~, ~~alcoholism~~, ~~hemochromatosis~~		*Handling/skin exposure
	*~~Exposure to marine~~/~~estuarine water~~, ~~ingestion of raw/undercooked shellfish~~ (~~oysters~~)		**Rapid [[cellulitis]] that progresses to hemorrhagic bullae and [[purpura fulminans]]
			**Wound infections can spread rapidly causing severe [[myositis]] and [[necrotizing fasciitis]]<ref>Choi HJ, Lee DK, Lee MW, Choi JH, Moon KC, Koh JK. Vibrio vulnificus septicemia presenting as purpura fulminans. J Dermatol. Jan 2005;32(1):48-51.</ref>
			*Ingestion:
			**[[Vomiting]], [[diarrhea]], and/or [[abdominal pain]]
			**+/- [[fever]], chills, or [[septic shock]]<ref>Choi HJ, Lee DK, Lee MW, Choi JH, Moon KC, Koh JK. Vibrio vulnificus septicemia presenting as purpura fulminans. J Dermatol. Jan 2005;32(1):48-51.</ref>

	==Differential Diagnosis==		==Differential Diagnosis==
			{{SSTI DDX}}
			{{Nausea and vomiting DDX}}

	==Evaluation==		==Evaluation==
			*Generally clinical diagnosis, though blood cultures may assist in ultimate diagnosis and vibrio PCR testing exists<ref>https://emedicine.medscape.com/article/1055523-workup</ref>
			*CT and surgical consult if concern for nec fas
			*CBC, BMP, LFTs if significant vomiting

	==Management==		==Management==
	*Severe infections should be treated with immediate antibiotics and ICU admission		*Severe infections should be treated with immediate antibiotics and ICU admission
	*May require aggressive surgical debridement		*May require aggressive surgical debridement
			*[[Doxycycline]] 100 mg IV or PO BID + [[ceftazidime]] 2g IV q8h<ref>https://www.aafp.org/afp/2007/0815/p539.html</ref>

	===[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>===		===[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>===
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	==Disposition==		==Disposition==
			*Contingent on presentation, admit if severe or significant comorbidities

	==See Also==		==See Also==
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	==References==		==References==
	<references/>		<references/>
			[[Category:ID]]

Wilkis5611: /* Background */

2019-08-26T19:21:30Z

Background

← Older revision		Revision as of 19:21, 26 August 2019
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	==Background==		==Background==
			*Gram negative bacterium living in marine environments
			*Leading cause of shellfish-associated death in US

	==Clinical Features==		==Clinical Features==
			*Fever, septic shock, bullous skin lesions
			*Wound infections can spread rapidly causing severe myositis and necrotizing fasciitis
			*More commonly seen in high risk patients: liver disease, alcoholism, hemochromatosis
			*Exposure to marine/estuarine water, ingestion of raw/undercooked shellfish (oysters)

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Management==		==Management==
			*Severe infections should be treated with immediate antibiotics and ICU admission
			*May require aggressive surgical debridement

	===[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>===		===[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>===

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-22T19:36:16Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 19:36, 22 July 2016
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	==Differential Diagnosis==		==Differential Diagnosis==

	==~~Diagnosis~~==		==Evaluation==

	==Management==		==Management==

Neil.m.young: Text replacement - "Pts " to "Patients "

2016-07-13T17:28:46Z

Text replacement - "Pts " to "Patients "

← Older revision		Revision as of 17:28, 13 July 2016
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	**Handling: rapid cellulitis that progresses to hemorrhagic bullae and purpura fulminans		**Handling: rapid cellulitis that progresses to hemorrhagic bullae and purpura fulminans
	**Ingestion: vomiting, diarrhea, or abdominal pain, and may present with fever, chills, or shock		**Ingestion: vomiting, diarrhea, or abdominal pain, and may present with fever, chills, or shock
	**~~Pts~~ with [[cirrhosis]] at high risk		**Patients with [[cirrhosis]] at high risk
	*Severe Complications<ref>Choi HJ, Lee DK, Lee MW, Choi JH, Moon KC, Koh JK. Vibrio vulnificus septicemia presenting as purpura fulminans. J Dermatol. Jan 2005;32(1):48-51.</ref>		*Severe Complications<ref>Choi HJ, Lee DK, Lee MW, Choi JH, Moon KC, Koh JK. Vibrio vulnificus septicemia presenting as purpura fulminans. J Dermatol. Jan 2005;32(1):48-51.</ref>
	**Necrotizing fasciitis and septicemia		**Necrotizing fasciitis and septicemia

Rossdonaldson1 at 07:38, 15 May 2016

2016-05-15T07:38:45Z

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 {{Vibrio species}}
-==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
+==Background==
 {| class="wikitable"
 | align="center" style="background:#f0f0f0;"|'''Category'''
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 |}
-===Key===
+====Key====
 {{Template:Antibacterial Spectra Key}}
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 [[Category:ID]]

Rossdonaldson1: /* Background */

2016-05-15T05:25:55Z

Background

← Older revision		Revision as of 05:25, 15 May 2016
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	**Immediate and intensive empirical antibiotic treatment		**Immediate and intensive empirical antibiotic treatment
	**Surgical debridement in suspected cases		**Surgical debridement in suspected cases

			{{Vibrio species}}

	==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==		==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==

Kxl328 at 06:02, 16 February 2016

2016-02-16T06:02:00Z

← Older revision		Revision as of 06:02, 16 February 2016
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	**Handling: rapid cellulitis that progresses to hemorrhagic bullae and purpura fulminans		**Handling: rapid cellulitis that progresses to hemorrhagic bullae and purpura fulminans
	**Ingestion: vomiting, diarrhea, or abdominal pain, and may present with fever, chills, or shock		**Ingestion: vomiting, diarrhea, or abdominal pain, and may present with fever, chills, or shock
			**Pts with [[cirrhosis]] at high risk
	*Severe Complications<ref>Choi HJ, Lee DK, Lee MW, Choi JH, Moon KC, Koh JK. Vibrio vulnificus septicemia presenting as purpura fulminans. J Dermatol. Jan 2005;32(1):48-51.</ref>		*Severe Complications<ref>Choi HJ, Lee DK, Lee MW, Choi JH, Moon KC, Koh JK. Vibrio vulnificus septicemia presenting as purpura fulminans. J Dermatol. Jan 2005;32(1):48-51.</ref>
	**Necrotizing fasciitis and septicemia		**Necrotizing fasciitis and septicemia

Arsmd: citation

2015-01-04T22:04:12Z

citation

← Older revision		Revision as of 22:04, 4 January 2015
Line 3:		Line 3:
	**Handling: rapid cellulitis that progresses to hemorrhagic bullae and purpura fulminans		**Handling: rapid cellulitis that progresses to hemorrhagic bullae and purpura fulminans
	**Ingestion: vomiting, diarrhea, or abdominal pain, and may present with fever, chills, or shock		**Ingestion: vomiting, diarrhea, or abdominal pain, and may present with fever, chills, or shock
	*Severe Complications		*Severe Complications<ref>Choi HJ, Lee DK, Lee MW, Choi JH, Moon KC, Koh JK. Vibrio vulnificus septicemia presenting as purpura fulminans. J Dermatol. Jan 2005;32(1):48-51.</ref>
	**Necrotizing fasciitis and septicemia		**Necrotizing fasciitis and septicemia
	**Immediate and intensive empirical antibiotic treatment		**Immediate and intensive empirical antibiotic treatment

Arsmd: addition of background information

2015-01-04T22:03:30Z

addition of background information

← Older revision		Revision as of 22:03, 4 January 2015
Line 1:		Line 1:
	==Background==		==Background==
			*History of handling or ingestion of raw seafood (most commonly oysters)
			**Handling: rapid cellulitis that progresses to hemorrhagic bullae and purpura fulminans
			**Ingestion: vomiting, diarrhea, or abdominal pain, and may present with fever, chills, or shock
			*Severe Complications
			**Necrotizing fasciitis and septicemia
			**Immediate and intensive empirical antibiotic treatment
			**Surgical debridement in suspected cases

	==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==		==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==