title: Vibrio vulnificus septicemia in a patient with the hemochromatosis HFE C282Y mutation.
abstract: Vibrio vulnificus is an extremely invasive gram-negative bacillus found in marine waters that causes overwhelming bacteremia and shock that is associated with high mortality. Impaired iron metabolism has been implicated in the susceptibility to V vulnificus bacterial infections. We report a case of fatal V vulnificus sepsis in a 56-year-old man who died within 1 to 3 days after consuming raw seafood. At autopsy, he was found to have micronodular cirrhosis and iron overload. Postmortem genetic analysis revealed the presence of the hemochromatosis gene (HFE) C282Y mutation. To our knowledge, this is this first documented fatal case of V vulnificus infection in a patient proven to carry the HFE C282Y mutation. Because this patient was heterozygous for the major hereditary hemochromatosis mutation and was not previously diagnosed with clinical iron overload, the spectrum of clinical susceptibilities to V vulnificus infection may include carriers of the C282Y mutation.
authors.affiliation: Department of Pathology, Dartmouth Medical School, VA Research Bldg Room 2-140, 215 N Main St, White River Junction, VT 05009, USA. Glenn.S.Gerhard@Dartmouth.edu
authors.forename: G S
authors.initials: GS
authors.lastname: Gerhard
authors.forename: K A
authors.initials: KA
authors.lastname: Levin
authors.forename: J
authors.initials: J
authors.lastname: Price Goldstein
authors.forename: M M
authors.initials: MM
authors.lastname: Wojnar
authors.forename: M J
authors.initials: MJ
authors.lastname: Chorney
authors.forename: D A
authors.initials: DA
authors.lastname: Belchis
mesh_terms: D000818:Animals; D016470:Bacteremia / Q000150:complications / Q000175:diagnosis; D004211:Disseminated Intravascular Coagulation / Q000382:microbiology; D017809:Fatal Outcome; D006680:HLA Antigens / Q000235:genetics*; D006432:Hemochromatosis / Q000150:complications / Q000235:genetics*; D000071020:Hemochromatosis Protein; D006579:Heterozygote; D015395:Histocompatibility Antigens Class I / Q000235:genetics*; D006801:Humans; D008297:Male; D008565:Membrane Proteins; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000382:microbiology; D009154:Mutation; D010125:Ostreidae / Q000382:microbiology; D017747:Seafood / Q000382:microbiology; D012871:Skin Diseases / Q000382:microbiology; D014735:Vibrio Infections / Q000150:complications / Q000175:diagnosis*
chemical_list: C103673:HFE protein, human; D006680:HLA Antigens; D000071020:Hemochromatosis Protein; D015395:Histocompatibility Antigens Class I; D008565:Membrane Proteins