title: Complicated sea urchin-induced wound infection caused byVibrioalginolyticusandStaphylococcus lugdunensisin a 14-year-old boy.
abstract: BACKGROUND
  Wound infections withVibrio alginolyticus, a Gram-negative bacterium found in all temperate oceans, are rarely reported. However, a rising incidence of wound infections caused byV. alginolyticusrequires better knowledge about this infectious agent.
  
  
  METHODS
  We report the case of a 14-year-old boy suffering from a wound infection caused byV. alginolyticusandStaphylococcus lugdunensisafter stepping on a sea urchin. Despite wound debridement and antibiotic therapy with cefaclor, the lesion did not heal over several weeks. After identification of the pathogens and antibiotic-susceptibility testing, antibiotic therapy was switched to ciprofloxacin, followed by trimethoprim/sulfamethoxazole. Two months after the accident the wound was re-epithelialized. Follow up after 6 months revealed a painful scar.
  
  
  CONCLUSIONS
  Non-cholera vibrios likeV. alginolyticusshould be considered as possible causative agents in seawater-contaminated wounds.S. lugdunensisis a relevant pathogen in mixed wound infections. Early microbiological diagnosis and antibiotic-susceptibility testing is crucial to prevent therapeutic failure.
authors.affiliation: Bioscientia Institut für Medizinische Diagnostik GmbH, Mikrobiologie/Infektiologie , Ingelheim , Germany.
authors.forename: Christoph André
authors.initials: CA
authors.lastname: Bultmann
authors.affiliation: University Children's Hospital, Giessen, Germany; Practice of Pediatrics, Fulda, Germany.
authors.forename: Jens-Oliver
authors.initials: JO
authors.lastname: Steiß
authors.affiliation: Practice of Pediatrics , Fulda , Germany.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Langner
authors.affiliation: Practice of Pediatrics , Fulda , Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Benkert
authors.affiliation: Bioscientia Institut für Medizinische Diagnostik GmbH, Mikrobiologie/Infektiologie , Ingelheim , Germany.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Havener
authors.affiliation: Bioscientia Institut für Medizinische Diagnostik GmbH, Mikrobiologie/Infektiologie , Ingelheim , Germany.
authors.forename: Uta
authors.initials: U
authors.lastname: Küsters
authors.affiliation: Institute of Food Hygiene, Free University of Berlin , Berlin , Germany.
authors.forename: Stephan Georg
authors.initials: SG
authors.lastname: Hühn-Lindenbein
authors.affiliation: Bioscientia Institut für Medizinische Diagnostik GmbH, Mikrobiologie/Infektiologie , Ingelheim , Germany.
authors.forename: Dietrich
authors.initials: D
authors.lastname: Mack
keywords: Staphylococcus lugdunensis; Vibrio; Vibrio alginolyticus; coagulase-negative staphylococci; sea urchin; wound