[Primary Vibrio vulnificus septicemia. 1st documented case in the French West Indies].
BACKGROUND
Vibrio vulnificus is a non-choleric halophilic vibrion widely distributed in marine environments. Contamination in humans is uncommon except in coastal areas of the United States and Asia. We report the first documented case in the French West Indies.


METHODS
A 57-year-old native with alcoholic cirrhosis was hospitalized for septic shock. The infectious syndrome began suddenly a few hours earlier with fever, diarrhea, and intense pain in the calf muscles. In the absence of a suspected agent, a wide spectrum antibiotic was prescribed. On day 3, bullae developed over the legs and progressed, despite early surgical debridement, to bilateral rapidly extensive necrosing cellulitis. An above the knee amputation was required but did not prevent death on day 9 due to irreversible multiple organ failure. Blood cultures were positive for V. vulnificus.


CONCLUSIONS
Primary septicemia due to V. vulnificus is mainly observed in subjects with an underlying liver disease and usually occurs after ingestion of contamined raw halieutic products such as oysters. The clinical presentation is characteristic with secondary necrotic ulcerations on the lower limbs. Improvement in the extremely poor prognosis of these infections depends on early initiation of an effective antibiotic with wide exeresis of necrotic tissue. Physicians should be aware of this severe infection despite its low frequency.
Lamaury
I
I
Service de Dermatologie et de Maladies infectieuses, CHU de Pointe-à-Pitre, Guadeloupe.
Bouregba
M
M
Mahé
A
A
Jarrige
B
B
Perez
J M
JM
Daijardin
J B
JB
Strobel
M
M
D016470:Bacteremia / Q000150:complications / Q000382:microbiology*; D019430:Guadeloupe; D006801:Humans; D008297:Male; D008875:Middle Aged; D014733:Vibrio / Q000145:classification; D014735:Vibrio Infections / Q000150:complications / Q000382:microbiology*