A 46-year-old Cirrhotic Man Presented with High Fever, Chills, Confusion, and Right Leg Swelling and Tenderness for 1 Day

Disseminated Vibrio vulnificus infection The morphology of the organism shown was suggestive for Vibrio or Aeromonas spp. (curved Gram-negative bacilli). Blood, joint and bleb fluids cultures of this patient eventually grew Vibrio vulnificus. The organism is primarily associated with severe, distinctive soft tissue infection and/or septicemia, especially in patients with cirrhosis1-3, because of its ability to invade the blood stream without causing gastrointestinal symptoms.1 More than 90 percent of septicemic patients have a history of having consumed raw oysters in the 7 days prior to illness. Early administration of antibiotics and surgical debridement (if indicated) are crucial for bacteremic and disseminated V. vulnificus infections, especially in immunocompromised patients even though the response rate is usually low. Tetracycline is the first-choice agent, with cefotaxime or ciprofloxacin as alternatives.1 The mortality may be high up to 33 percent despite early antibiotic therapy and surgical debridement.2,3