Lower extremity infections by vibrio vulnificus.
BACKGROUND
Vibrio vulnificus is a Gram-negative pathogen which is found in seawater and shellfish during warm months and can cause local infections in healthy individuals or septicemia in patients with chronic liver disease.


METHODS
Clinical and laboratory records of four complicated cases are presented, with a 4.2 mean year follow-up.


RESULTS
Three patients underwent urgent leg amputation because of of irreversible necrotic changes with septic complications and failure of incisional drainage to control the infection. Another one patient underwent only excision of necrotic soft tissue but he developed calcaneus osteomyelitis after three years of the initial fish bone injury.


CONCLUSIONS
Clinicians must maintain a high index of suspicion, especially in regions endemic for vibrio necrotising fasciitis and antibiotic prophylaxis must be given to swimmers before or during bathing.
Mouzopoulos
G
G
Department of Evangelismos Hospital, Athens, Greece.
Stamatakos
M
M
Tzurbakis
M
M
Batanis
G
G
Michou
E
E
Mouzopoulos
D
D
Tsembeli
A
A
Iannescu
R
R
Safioleas
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019115:Fasciitis, Necrotizing / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000601:surgery / Q000628:therapy*; D005260:Female; D005399:Fishes; D005528:Foot; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007866:Leg; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014735:Vibrio Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery / Q000628:therapy*; D041261:Vibrio vulnificus / Q000302:isolation & purification*
D000900:Anti-Bacterial Agents