Vibrio parahemolyticus: Difference between revisions
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==Background== | ==Background== | ||
*Shellfish exposure | *Shellfish exposure, especially raw oysters | ||
*Salt water contact with skin lesion | |||
{{Vibrio species}} | {{Vibrio species}} | ||
| Line 6: | Line 7: | ||
==Clinical Features== | ==Clinical Features== | ||
* | *Gastroenteritis > wound infection >> sepsis | ||
*sepsis is less common, but typically occurs 7 to 48 hours after raw oyster ingestion => fever, chills, nausea/vomiting, abdominal pain => shock, bullae => death in approximately 55% <ref>Blake PA, Merson MH, Weaver RE, Hollis DG, Heublein PC. Disease caused by a marine Vibrio. Clinical characteristics and epidemiology.[[http://www.ncbi.nlm.nih.gov/pubmed/758155 N Engl J Med. 1979 Jan 4;300(1):1-5.]</ref> | |||
* | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Nausea and vomiting DDX}} | |||
==Evaluation== | ==Evaluation== | ||
*Diagnosis is clinical (e.g. shellfish consumption + gastroenteritis, saltwater contact with lesion) | |||
*Check electrolytes for repletion if significant vomiting/diarrhea | |||
==Management== | ==Management== | ||
*Hydration (e.g. [[ORS]]) | *[[Gastroenteritis]] | ||
*[[ | **Hydration (e.g. [[ORS]]) | ||
**Antibiotics ([[Floroquinolone]] OR [[doxycycline]]) only in severe or prolonged cases | |||
**Notify public health authorities if epidemic food-borne illness is suspected | |||
*Sepsis, Wound Infections | |||
**Treat severe disease only | **Treat severe disease only | ||
**[[Floroquinolone]] OR [[doxycycline]] OR third-generation [[cephalosporin]] | **[[Floroquinolone]] OR [[doxycycline]] OR third-generation [[cephalosporin]] | ||
**Treat for 7 to 14 days | |||
*[[Necrotizing Fasciitis]] | |||
**Emergent surgical consultation for debridement | |||
==Disposition== | ==Disposition== | ||
==See Also== | ==See Also== | ||
*[[Gastroenteritis]] | |||
*[[Necrotizing Fasciitis]] | |||
*[[Vibrio species]] | |||
==External Links== | ==External Links== | ||
Latest revision as of 18:34, 10 August 2016
Background
- Shellfish exposure, especially raw oysters
- Salt water contact with skin lesion
Vibrio species
Clinical Features
- Gastroenteritis > wound infection >> sepsis
- sepsis is less common, but typically occurs 7 to 48 hours after raw oyster ingestion => fever, chills, nausea/vomiting, abdominal pain => shock, bullae => death in approximately 55% [1]
Differential Diagnosis
Nausea and vomiting
Critical
Emergent
- Acute radiation syndrome
- Acute gastric dilation
- Adrenal insufficiency
- Appendicitis
- Bowel obstruction/ileus
- Carbon monoxide poisoning
- Cholecystitis
- CNS tumor
- Electrolyte abnormalities
- Elevated ICP
- Gastric outlet obstruction, gastric volvulus
- Hyperemesis gravidarum
- Medication related
- Pancreatitis
- Peritonitis
- Ruptured viscus
- Testicular torsion/ovarian torsion
Nonemergent
- Acute gastroenteritis
- Biliary colic
- Cannabinoid hyperemesis syndrome
- Chemotherapy
- Cyclic vomiting syndrome
- ETOH
- Gastritis
- Gastroenteritis
- Gastroparesis
- Hepatitis
- Labyrinthitis
- Migraine
- Medication related
- Motion sickness
- Narcotic withdrawal
- Thyroid
- Pregnancy
- Peptic ulcer disease
- Renal colic
- UTI
Evaluation
- Diagnosis is clinical (e.g. shellfish consumption + gastroenteritis, saltwater contact with lesion)
- Check electrolytes for repletion if significant vomiting/diarrhea
Management
- Gastroenteritis
- Hydration (e.g. ORS)
- Antibiotics (Floroquinolone OR doxycycline) only in severe or prolonged cases
- Notify public health authorities if epidemic food-borne illness is suspected
- Sepsis, Wound Infections
- Treat severe disease only
- Floroquinolone OR doxycycline OR third-generation cephalosporin
- Treat for 7 to 14 days
- Necrotizing Fasciitis
- Emergent surgical consultation for debridement
Disposition
See Also
External Links
References
- ↑ Blake PA, Merson MH, Weaver RE, Hollis DG, Heublein PC. Disease caused by a marine Vibrio. Clinical characteristics and epidemiology.[N Engl J Med. 1979 Jan 4;300(1):1-5.