By Gary M. White, MD
Vibrio vulnificusn (VV) is a serious infection that may be acquired from eating raw oysters, or thru contamination of open wounds
- VV is a gram-negative bacillus that lives in warm costal waters, e.g. the Gulf of Mexico, where it colonizes marine life such as oysters.
- It is not a result of human waste contamination.
- Ingestion of raw oysters leads to septicemia, most commonly in those with compromised immune systems, impaired hepatic function and/or iron overload.
- Local infection may also occur after contamination of open wounds.
Localized areas of erythema, hemorragic bulla and necrosis one week after ingesting raw oysters is the classic history. Edema and subcutaneous bleeding (e.g. ecchymosis and purpura) may also be seen. Necrosis as is typical of necrotizing fasciitis is uncommon [J Infect 1998;36;313]. A high level of serum CPK is typical [BJD 2001;145;280]. CPK is usually normal in cellulitis and erysipelas, but may be elevated in necrotizing fasciitis.
A gastroenteritis may accompany the cutaneous changes. The disease may be fatal. In one study, more than half of the septicemic patients died. 83% of patients with primary septicemia with VV reported eating raw oysters during the week before onset of illness [J Infect Dis 1996;173;1176].
An infectious disease specialist should be consulted. Large doses of tetracycline are needed. Debridement may be necessary.
Clinical Infectious Disease
JAAD November 2009;Volume 61, Issue 5, Pages 733–750
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