title: Snakebite complicated with Vibrio vulnificus infection.
abstract: Snakebite may be complicated with bacteria infections, most of which are Gram-negative bacillus. Snakebite complicated with Vibrio vulnificus infection has not been reported previously. Vibrio vulnificus infection is characterized by a necrotizing wound infection similar to the local lesion of severe snakebite. In Vibrio infections, aggressive debridement with the administration of strong antibiotics as early as possible is the only effective treatment. We report a 79-y-o man who suffered from snakebite on the right palm with rapid progression of hemorrhagic bulla, necrotizing fasciitis, compartment syndrome, and septic shock. Vibrio vulnificuswas cultured from necrotic tissue after aggressive debridement and fasciotomy. The patient recovered from antibiotic treatment and several courses of reconstruction surgery. Severe bacteria infection, such as caused by Vibrio vulnificus, should be considered in snakebite cases refractory to antivenin dosage.
authors.affiliation: Department of Emergency Medicine, Taichung Veterans General Hospital, Taiwan.
authors.forename: C H
authors.initials: CH
authors.lastname: Wu
authors.forename: W H
authors.initials: WH
authors.lastname: Hu
authors.forename: D Z
authors.initials: DZ
authors.lastname: Hung
authors.forename: Y C
authors.initials: YC
authors.lastname: Peng
authors.forename: D Y
authors.initials: DY
authors.lastname: Yang
mesh_terms: D000368:Aged; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003646:Debridement; D018450:Disease Progression; D019115:Fasciitis, Necrotizing / Q000209:etiology; D000071938:Fasciotomy; D006225:Hand; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures; D012772:Shock, Septic / Q000209:etiology; D012909:Snake Bites / Q000150:complications*; D016896:Treatment Outcome; D014733:Vibrio / Q000302:isolation & purification / Q000472:pathogenicity*; D014735:Vibrio Infections / Q000473:pathology*
chemical_list: D000900:Anti-Bacterial Agents