Infection and Drug Resistance (Nov 2021)
Septic Shock Induced by Vibrio Vulnificus in Northern Poland, a Case Report
Abstract
Bogusz Jan Aksak-Wąs,1 Agnieszka Ripa,2 Paweł Szakoła,3 Karolina Horbacka,3 Jolanta Niścigorska-Olsen,2 Magdalena Witak-Jędra,2 Małgorzata Zając-Marczewska,2 Malwina Karasińska-Cieślak,2 Jacek Kot,4 Miłosz Parczewski1 1Department of Infectious, Tropical Diseases and Immune Deficiency, Pomeranian Medical University in Szczecin, Szczecin, Poland; 2Department of Infectious, Tropical Diseases and Immune Deficiency, Provincial Hospital, Szczecin, Poland; 3Department of General and Transplant Surgery, Department of Vascular Surgery, Provincial Hospital, Szczecin, Poland; 4National Center for Hyperbaric Medicine, University Center for Maritime and Tropical Medicine in Gdynia, Medical University of Gdansk, Gdansk, PolandCorrespondence: Bogusz Jan Aksak-Wąs Email [email protected]: Vibrio vulnificus infections are a growing problem worldwide. In recent years, infections with this bacteria have been reported in Central Europe, especially in the German Baltic coast but also in France and Italy. Climate warming causes the sea temperature to increase every year, which translates to an increased risk of infections from the Vibrio group. Most of these are mild and present as wound infections, but some patients develop life-threatening sepsis from either ingestion of infected mollusks or wound lesions that develop into generalized infections. Illness may be associated with necrotizing fasciitis and may require several weeks of therapy, often based on a surgical operation, demarcation of necrosis or limb amputation. A case such as the one described in this manuscript has not been previously described in Poland and demonstrates the need for a multidisciplinary approach to infection with Vibrio vulnificus.Case Presentation: A 68-year-old patient was pricked with an unknown object in the side of a lower limb during his stay at the Polish seaside. He developed a life-threatening infection in the form of severe sepsis with multiple organ failure. He required broad-spectrum antibiotic therapy, and after obtaining results for Vibrio vulnificus targeted therapy, a surgical operation with skin lesion decompression and fasciotomy was performed. Finally, hyperbaric chamber therapy was given. The patient’s general condition improved, and local changes and his vital parameters stabilized.Conclusion: Vibrio vulnificus infection may be confused with other causes of skin and subcutaneous tissue infection, although it requires a different approach and different targeted antibiotic therapies. This infection may take the form of a life-threatening disease requiring a multidisciplinary approach.Keywords: case report, Vibrio vulnificus, sepsis shock, crustaceans, hyperbaric chamber
