SHM Converge Scientific Abstract ePoster Gallery-A Rare Case of Necrotizing Fasciitis and Septic Shock Caused by Vibrio Vulnificus

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This poster describes a rare, severe case of necrotizing fasciitis and septic shock caused by <strong>Vibrio vulnificus</strong>, a halophilic gram-negative bacterium found in marine environments. Vibrio infections are uncommon in the U.S., but they can be highly lethal, especially in patients with <strong>chronic liver disease, diabetes, or immunodeficiency</strong>.

The case involves a <strong>51-year-old man with alcoholic cirrhosis</strong> who developed severe bilateral leg pain, nausea, vomiting, and diarrhea about <strong>36 hours after eating raw oysters</strong>. On exam, he was encephalopathic and had warm, tender lower extremities with ecchymoses and hemorrhagic bullae extending from both feet to the ankles, with more extensive involvement of the right leg. Laboratory and imaging findings supported severe infection, and his <strong>LRINEC score was 7</strong>, raising concern for necrotizing soft tissue infection.

He was treated immediately with <strong>vasopressors</strong> for septic shock and broad-spectrum empiric antibiotics including vancomycin, clindamycin, doxycycline, and cefepime. Due to suspected necrotizing fasciitis, he underwent <strong>emergent surgical debridement and right lower extremity guillotine amputation</strong>, later formalized as a <strong>right above-knee amputation</strong>. Blood and wound cultures confirmed <strong>V. vulnificus</strong>, and antibiotics were narrowed to <strong>doxycycline and ceftriaxone</strong> based on susceptibility.

The discussion emphasizes that <strong>V. vulnificus necrotizing fasciitis can progress rapidly to multiorgan failure and has a mortality rate exceeding 50% in primary septicemia</strong>. Early recognition, prompt antibiotics, and surgical source control are critical for survival. The poster also highlights prevention: patients with liver disease should avoid raw oysters and shellfish, and those with open wounds should avoid exposure to warm seawater.

Asset Subtitle

Zoheb I. Sulaiman

Meta Tag

Author List Lauren N. Herrera, Orlando Turner, Zoheb I. Sulaiman

Category Clinical Vignettes

Concept Vibrio vulnificus

Concept Necrotizing Fasciitis

Concept Septic Shock

Concept Hemorrhagic bullae

Concept Liver Disease

Distinguished Non-Finalist

Presenter Organization AU/UGA Medical Partnership at St. Mary's Hospital

Presenting Author Zoheb I. Sulaiman

Track Adult

Keywords

Vibrio vulnificus

necrotizing fasciitis

septic shock

raw oysters

alcoholic cirrhosis

marine bacteria

hemorrhagic bullae

emergent debridement

above-knee amputation

antibiotic therapy

Vibrio vulnificus

Necrotizing Fasciitis

Septic Shock

Hemorrhagic bullae

Liver Disease