SHM Converge Scientific Abstract ePoster Gallery-Unmasking the Unusual: A Case of Unpredictable Primary Septicemia Caused by Vibrio Vulnificus

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This document describes a fatal case of <strong>Vibrio vulnificus</strong> infection, a gram-negative bacterium that causes severe human illness, especially in people with liver disease, alcoholism, hemochromatosis, or other chronic conditions. The bacterium is commonly found in warm brackish water and is associated with raw or undercooked shellfish, particularly oysters. It can cause wound infections or <strong>primary septicemia</strong>, a bloodstream infection without a clear external source. Primary septicemia often leads to rapid shock, hypotension, thrombocytopenia, DIC, and a very high mortality rate.

The case involved a <strong>52-year-old woman</strong> with a history of gastric bypass surgery, alcohol use disorder, and hypertension. She presented with <strong>severe bilateral leg pain</strong>, feverishness, weakness, lactic acidosis, elevated liver function tests, and hypotension requiring ICU admission and vasopressors. Although she had recently fallen, the pain was out of proportion to the injury. CT imaging of the legs showed no necrotizing fasciitis. CT of the abdomen and pelvis showed gallbladder wall thickening and a cirrhotic liver, leading to initial treatment for possible acute cholecystitis and empiric antibiotics. Blood cultures later grew gram-negative rods and ultimately confirmed <strong>Vibrio vulnificus</strong>.

Despite treatment, her condition worsened with increasing lactic acid, worsening coagulopathy, thrombocytopenia, severe sepsis, DIC, and multiple organ failure. She died <strong>four days after admission</strong>.

The report highlights the danger of V. vulnificus infections, the difficulty of early diagnosis, and the importance of recognizing high-risk patients—especially those with liver disease and septic shock—because mortality can be extremely high.

Asset Subtitle

Saad Malik

Meta Tag

Author List Mifrah Sherwani, Saad Malik

Category Clinical Vignettes

Concept Vibrio vulnificus

Concept Septicemia

Concept Liver Disease

Concept Raw shellfish

Concept Undercooked shellfish

Distinguished Non-Finalist

Presenter Organization Texas Health Resources HEB/Denton

Presenting Author Saad Malik

Track Adult

Keywords

Vibrio vulnificus

primary septicemia

severe sepsis

bloodstream infection

liver disease

alcohol use disorder

oysters

brackish water

distributive shock

disseminated intravascular coagulation

Vibrio vulnificus

Septicemia

Liver Disease

Raw shellfish

Undercooked shellfish