Vibrio vulnificus Septicemia after Handling Tilapia Species Fish: A Canadian Case Report and Review

Abstract

The present case highlights the need to consider V vulnificus in the microbiological differential diagnosis when a person presents with sepsis and bullous cutaneous lesions. The importance of educating patients with liver disease (and certain other chronic diseases) about the need to be cautious when handling or consuming seafood is underscored.

Necrotizing wound infection from a tilapia fish injury

“…All patients suspected of having V. vulnificus infection should undergo further assessment for clinical manifestations of sepsis. After consumption of raw seafood or contaminated food, the presence of hemorrhagic bullae on the lower extremities may be a sign of this infection, 7 as in our patient's case. Timely expert consultation should be considered.…”

“…We are aware of three reported cases, the most recent being 10 years ago, when a patient died from a necrotizing wound infection sustained while handling a tilapia fish. 7 The case was unrelated to local marine water exposure, but traced to a…”

“…9 In general, first-line therapy combines a parenteral third-generation cephalosporin with a tetracycline, which should be given orally while waiting for the intravenous formulation in centres with delayed access. 7 In addition, prompt and serial surgical evaluations for early débridement in necrotizing wound infections are critical to treatment and preventing amputation. …”

Genetic Characterization of Vibrio vulnificus Strains from Tilapia Aquaculture in Bangladesh

“…Alleles include 16S rRNA loci (15, 26, 42), a virulence-correlated gene (vcg) locus (31, 41, 42), and repetitive sequence in the CPS operon (12). DiversiLab repetitive extrageneic palindromic (rep-PCR) analysis also confirmed these genetic distinctions and showed greater diversity among clinical strains (12).Wound infections associated with tilapia in Israel implicated aquaculture as a potential source of V. vulnificus in human disease (6,40). Tilapia aquaculture is increasing rapidly, as shown by a 2.8-fold increase in tons produced from 1998 to 2007 (Food and Agriculture Organization; http://www.fao.org /fishery/statistics/en).…”

“…Wound infections associated with tilapia in Israel implicated aquaculture as a potential source of V. vulnificus in human disease (6,40). Tilapia aquaculture is increasing rapidly, as shown by a 2.8-fold increase in tons produced from 1998 to 2007 (Food and Agriculture Organization; http://www.fao.org /fishery/statistics/en).…”