Vibrio vulnificus bacteremia associated with chronic lymphocytic leukemia, hypogammaglobulinemia, and hepatic cirrhosis: relation to host and exposure factors in 252 V. vulnificus infections reported in Louisiana.
BACKGROUND
Vibrio vulnificus infection in persons with B-chronic lymphocytic leukemia (B-CLL) or hypogammaglobulinemia has been reported infrequently.


METHODS
A woman with B-CLL, hypogammaglobulinemia, and hepatic cirrhosis died of V. vulnificus bacteremia after eating cooked shrimp and crabs. We reviewed host and exposure data in 252 cases of V. vulnificus infection reported in Louisiana during the interval of 1980 through 2004.


RESULTS
V. vulnificus was isolated from blood in 122 cases (48.8%). Preexisting conditions in 138 cases included liver disease (41.3%), malignancy (13.8%), and immunosuppression (9.4%). The prevalence of preexisting conditions was significantly greater in cases with positive blood cultures than in cases with positive wound or stool cultures. Exposure data in 116 cases revealed crab consumption without raw oyster consumption or seawater exposure in 3.4%.


CONCLUSIONS
The present patient had several conditions associated with increased risk of V. vulnificus infection and bacteremia, especially hepatic cirrhosis, but her route of exposure to V. vulnificus was unusual.
Barton
James C
JC
Southern Iron Disorders Center, and the Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama 35029, USA. ironmd@dnamail.com
Ratard
Raoult C
RC
D000293:Adolescent; D000328:Adult; D000361:Agammaglobulinemia / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D000368:Aged; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005517:Foodborne Diseases / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D016867:Immunocompromised Host; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007223:Infant; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D008103:Liver Cirrhosis / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D008145:Louisiana; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D017747:Seafood / Q000382:microbiology; D014735:Vibrio Infections / Q000453:epidemiology* / Q000209:etiology; D041261:Vibrio vulnificus