title: Survival case of Vibrio vulnificus infection with multiple endocrine neoplasia type I.
abstract: A 35-year-old female with malabsorption syndrome who underwent a pancreatoduodenectomy for multiple endocrine adenomatosis 13 years prior was admitted to our hospital with diarrhea, general fatigue, high fever, and eruption in the lower legs. The patient had consumed raw shrimp a few days before onset and presented systemic inflammatory response syndrome at the time of hospitalization. Vibrio vulnificus was isolated from a blood culture performed before admission to the intensive care unit. We excised necrotizing tissue in the legs after improvement of her general condition. During the treatment process, glucose, catecholamine, and appropriate antibiotics were administered for hypoglycemia, hypotension, and high fever, respectively. The patient was discharged 107 days after contracting the disease. Of 18 septic patients with V. vulnificus infection admitted to our hospital, this was the first to develop septicemia in the absence of a previous liver dysfunction. In order to prevent this type of fatal infection, public education for immuno-compromised individuals as well as those with liver disease is essential. For early diagnosis and appropriate treatment, more effective strategies are required, such as the establishment of a network system where family physicians and emergency hospital staff could discuss information regarding high-risk patients.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Saga University, Faculty of Medicine.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Amemori
authors.forename: Masaki
authors.initials: M
authors.lastname: Hyakutake
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Maeda
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Tomita
authors.forename: Shinji
authors.initials: S
authors.lastname: Mitsumizo
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Oishi
authors.forename: Shunzo
authors.initials: S
authors.lastname: Koizumi
authors.forename: Mikio
authors.initials: M
authors.lastname: Nakashima
authors.forename: Kazukuni
authors.initials: K
authors.lastname: Araki
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002395:Catecholamines / Q000008:administration & dosage; D002442:Ceftazidime / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D019115:Fasciitis, Necrotizing / Q000209:etiology / Q000628:therapy; D005260:Female; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D016867:Immunocompromised Host; D008286:Malabsorption Syndromes / Q000150:complications; D008911:Minocycline / Q000008:administration & dosage; D018761:Multiple Endocrine Neoplasia Type 1 / Q000150:complications*; D018805:Sepsis / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome; D014735:Vibrio Infections / Q000209:etiology* / Q000628:therapy*; D041261:Vibrio vulnificus
chemical_list: D000900:Anti-Bacterial Agents; D002395:Catecholamines; D002442:Ceftazidime; D008911:Minocycline; D005947:Glucose