[Necrotizing dermatitis due to Vibrio Vulnificus].
BACKGROUND
Vibrio vulnificus is a Gram-negative halophilic pathogen for man that can cause septicemia in patients with chronic liver disease. In healthy subjects, infections are generally local or regional. We report two cases of necrotizing dermo-hypodermitis due to Vibrio vulnificus.


METHODS
The first patient was a 21-year-old fisherman who developed extensive necrotizing dermo-hypodermitis 24 hours after a penetrating scratch with a fish bone. The second patient was also a fisherman. This 35-year-old man developed a massive area of necrotic tissue on the left leg, also 48 hours after a penetrating fish bone scratch. Both patients exhibited neutrophil hyperleukocytosis and thrombocytopenia. Bacteriological study of the pus and damaged tissue identified Vibrio vulnificus. Blood cultures were negative. Liver tests and liver ultrasound were normal. The course was favorable in both cases with antibiotic treatment and excision of the necrotic tissue.


CONCLUSIONS
For these two cases of Vibrio vulnificus necrotizing dermo-hypodermitis, the diagnosis was based on epidemiological, clinical and bacteriological arguments. Neither of these patients had liver disease, explaining the limited locoregional nature of the infection. The severity of the skin necrosis and its rapid course are related to the toxins produced by V. vulnificus. Curative medical and surgical care is generally effective in cases without septicemia and prognosis is good. Education of exposed subjects, fishermen and patients with chronic liver disease, should be helpful for prevention.
Dieng
M T
MT
Service de Dermatologie, CHU Le Dantec, Dakar, Sénégal.
Niang
S O
SO
Ly
F
F
Bathily
T
T
Ndiaye
B
B
D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents; D001842:Bone and Bones; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005399:Fishes; D006801:Humans; D008297:Male; D009336:Necrosis; D011379:Prognosis; D012675:Senegal; D017192:Skin Diseases, Bacterial / Q000382:microbiology* / Q000473:pathology* / Q000628:therapy; D016038:Skin Transplantation; D016896:Treatment Outcome; D014733:Vibrio / Q000145:classification; D014735:Vibrio Infections / Q000382:microbiology* / Q000473:pathology* / Q000628:therapy; D014950:Wounds, Penetrating / Q000150:complications*
D000900:Anti-Bacterial Agents