Global climate change and wound care: case study of an off-season vibrio alginolyticus infection in a healthy man.
Vibrio alginolyticus is a halophilic Gram-negative bacterium normally present in seawater. Vibrios are not capable of cutaneous invasion through intact skin and their isolation from extraintestinal sites is uncommon. However, interruptions in skin integrity (cuts or abrasions) can allow these bacteria to cause complicated skin and soft tissues infections. This case study describes the clinical assessment and management of a nonhealing traumatic wound, sustained in a coastal area during the winter months, in a healthy 70-year-old man. Culture results were positive for V. alginolyticus. Appropriate antibiotic treatment and topical wound care successfully resolved the infection. V. alginolyticus infections are usually benign; respond well to treatment, even with local therapy only; and tend to result from contact with warm ocean water. The clinical characteristics of the wound prompted a suspicion of a Vibrio infection even though the wound was sustained in the winter time and the patient did not have direct contact with ocean water. Although other case studies of Vibrio infections in the absence of direct contact with ocean water have been published, increased ocean temperatures due to global climate changes may explain the out-of-season infection in this patient. Clinicians should monitor the progression of wound healing and be prepared to modify treatment based on individual circumstances, especially in the case of unusual wound presentation, nonhealing, or a progressing wound infection.
Sganga
Gabriele
G
Catholic University of Sacred Heart, Department of Surgery, Policlinico, Roma, Italy. gsganga@tiscali.it
Cozza
Valerio
V
Spanu
Teresa
T
Spada
Pier Luigi
PL
Fadda
Giovanni
G
D000368:Aged; D001706:Biopsy; D004269:DNA, Bacterial / Q000032:analysis / Q000235:genetics; D017752:Greenhouse Effect; D006801:Humans; D007869:Leg Injuries / Q000150:complications; D008297:Male; D016133:Polymerase Chain Reaction; D012307:Risk Factors; D012621:Seasons; D012623:Seawater / Q000382:microbiology; D017592:Skin Care / Q000379:methods; D014735:Vibrio Infections / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D044149:Vibrio alginolyticus / Q000235:genetics; D014871:Water Microbiology; D014945:Wound Healing; D014946:Wound Infection / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D014950:Wounds, Penetrating / Q000150:complications
D004269:DNA, Bacterial