title: Lower extremity infections by vibrio vulnificus.
abstract: 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.
authors.affiliation: Department of Evangelismos Hospital, Athens, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Mouzopoulos
authors.forename: M
authors.initials: M
authors.lastname: Stamatakos
authors.forename: M
authors.initials: M
authors.lastname: Tzurbakis
authors.forename: G
authors.initials: G
authors.lastname: Batanis
authors.forename: E
authors.initials: E
authors.lastname: Michou
authors.forename: D
authors.initials: D
authors.lastname: Mouzopoulos
authors.forename: A
authors.initials: A
authors.lastname: Tsembeli
authors.forename: R
authors.initials: R
authors.lastname: Iannescu
authors.forename: M
authors.initials: M
authors.lastname: Safioleas
mesh_terms: 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*
chemical_list: D000900:Anti-Bacterial Agents