Vibrio vulnificus infection in São Paulo, Brazil: case report and literature review

Abstract

Non cholera Vibrio may cause conjunctivitis, wound infection, gastroenteritis and serious sepsis. Transmission to men is through contact with skin, mucosa or wounds exposed to marine water, and consumption of certain barely cooked or raw seafood, more frequently in the summer. This is one of the first cases of severe infection related to Vibrio vulnificus described in Brazil. The patient was an old man, who ingested seafood in Guarujá, a seashore city near São Paulo, 3 days before hospitalization. He was admitted to the emergency room in an ill state with septic shock. On 2 sets of blood culture a highly virulent microorganism was isolated, Vibrio vulnificus, which leads to sepsis and frequently to death in susceptible patients. The objective of this report was to use this case to discuss clinical aspects, microbiological diagnosis and treatment of the infection caused by this agent, besides the review of epidemiology, associated risk factors and prevention before consuming or getting in contact with seafood, especially in patients with greater susceptibility to this kind of infection.

A comprehensive review of Vibrio vulnificus: an important cause of severe sepsis and skin and soft-tissue infection

“…Among the classes of antimicrobial drugs reliably active against the organism are third-generation cephalosporins (cefotaxime, ceftriaxone, or ceftazidime), betalactam-beta-lactamase inhibitors (piperacillin-tazobactam), carbapenems (imipenem-cilastatin), tetracyclines (minocycline or doxycycline), aminoglycosides (gentamicin or amikacin), fluoroquinolones (ciprofloxacin, moxifloxacin, or levofloxacin), and miscellaneous agents such as trimethoprim-sulfamethoxazole or chloramphenicol. [75][76][77][78][79][80][81] The CDC recommends treatment of wound infections in adults with ceftazidime 1 to 2 g IV/intramuscular (IM) every 8 h in combination with doxycycline 100 mg IV/peroral (PO) twice daily (7 to 14 days). The literature consensus for primary sepsis is similar, with ceftazidime 2 g IV every 8 h in combination again with doxycycline 100 mg IV/PO every 12 h. Combination antimicrobial therapy appears to be the preferred regimen for serious infection, although some animal studies suggest monotherapy (e.g., fluoroquinolone) may be just as effective.…”

Vibrio parahaemolyticusandVibrio vulnificusin South America: water, seafood and human infections

“…The patient died after 12 days, due to fungaemia caused by Candida albicans (Araujo et al . ). The third case in Brazil occurred in Paraná State, in 2013.…”

A Strain of Bacillus amyloliquefaciens Can Prevent Vibrio vulnificus Colonization in Crassostrea gigas Oysters

“…The risk of V. vulnificus infection is higher in individuals with a compromised immune system, such as people with chronic liver disease, alcoholism, diabetes, and hemochromatosis (Bross et al, 2007;Barton and Acton, 2009;Yun and Kim, 2018). The Centers for Disease Control and Prevention of the United States (CDC) estimates that around 80,000 people get vibrio infections every year, including 500 hospitalizations and 100 deaths, with V. vulnificus as the most prevalent causal agent (Araujo et al, 2007;Scallan et al, 2011;Oliver, 2015;CDC, 2018).…”