Systemic vibrio infection presenting as necrotizing fasciitis and sepsis: A series of thirteen cases

Yao Hung Tsai, Robert Wen Wei Hsu, Kuo Chin Huang, Chih Hung Chen, Chin Chang Cheng, Kuo Ti Peng, Tsung Jen Huang

研究成果: 雜誌貢獻文章同行評審

51 引文 斯高帕斯(Scopus)

摘要

Background: Vibrio species are an uncommon cause of necrotizing fasciitis and primary septicemia, which are likely to occur in patients with hepatic disease, diabetes mellitus, adrenal insufficiency, and immunocompromised conditions. These organisms are found in warm sea waters and are often present in raw oysters, shellfish, and other seafood. The purposes of the present report were to describe a series of patients who had this potentially lethal infection and to identify clinical features associated with a poor prognosis. Methods: We retrospectively reviewed the records of thirteen patients (ten men and three women) who had necrotizing fasciitis and sepsis caused by Vibrio species. All patients had a history of contact with seawater or raw seafood. Eight patients had a hepatic disease such as hepatitis or cirrhosis of the liver, three had diabetes mellitus (without hepatic disease), and two had chronic renal or adrenal insufficiency (without hepatic disease). Results: Twelve patients underwent fasciotomy or limb amputation. Five patients (38%) died within two to six days after admission, and eight patients survived. Patients with a systolic blood pressure of ≤90 mm Hg and leukopenia in the emergency room had a significantly higher mortality rate (p <0.05). Conclusions: The diagnosis of Vibrio necrotizing fasciitis should be suspected when a patient has the appropriate clinical findings and a history of contact with seawater or raw seafood. The treatment should begin as early as possible, essentially when the patient has symptoms of sepsis. Although emergency fasciotomy or limb amputation did not reduce the mortality rate in this series, we consider such operations to be an important aspect of treatment. Level of Evidence: Prognostic study, Level IV (case series). See Instructions to Authors for a complete description of levels of evidence.
原文英語
頁(從 - 到)2497-2502
頁數6
期刊Journal of Bone and Joint Surgery - Series A
86
發行號11
出版狀態已發佈 - 十一月 2004
對外發佈

ASJC Scopus subject areas

  • 手術
  • 骨科和運動醫學

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