Secondary septic shock triggered by vibrio vulnificus infection: A case report
image: Morphological characteristics of isolated Vibrio vulnificus from patient specimens. (A) Gram stain microscopy of patient’s blood culture (×1 000 magnification); (B) Growth of Vibrio vulnificus on blood agar plate; (C) Growth of Vibrio vulnificus on haemophilus chocolate agar plate; (D) Growth of Vibrio vulnificus on TCBS agar plate
Credit: Shuai Zu, Li Lin, Ming-hui Wen, Heng-rui Zhao, Xiu-mei Hu, Lei Zheng.
Extended Summary
This peer-reviewed case report documents a rare and rapidly progressing infection caused by Vibrio vulnificus, resulting in secondary septic shock in a 56-year-old man following a minor cut sustained while handling raw shrimp in his kitchen. The case is notable due to the speed and severity of disease progression, the identification process of the pathogen, and the successful outcome following aggressive intervention.
Clinical Presentation and History
The patient presented to the emergency department with fever, hypotension, skin lesions, and limb swelling shortly after sustaining a small cut on his left middle finger. Within 24 hours, the infection had spread aggressively, forming necrotic bullae, causing extensive soft tissue damage, and leading to multi-organ dysfunction. The patient had underlying chronic conditions such as hypertension, hyperlipidemia, and fatty liver, but no immunocompromising diseases.
Diagnosis and Microbiological Findings
· Initial imaging revealed soft tissue gas formation, suggesting necrotizing fasciitis.
· Wound and blood cultures identified Vibrio vulnificus.
· Identification was confirmed by MALDI-TOF mass spectrometry and next-generation sequencing (NGS), which showed high read counts for V. vulnificus with no evidence of mixed infection.
· Laboratory data showed elevated inflammatory markers and rapid deterioration of renal and hepatic function.
Treatment and Management
· The patient was immediately treated with broad-spectrum antibiotics, later narrowed to cefoperazone–sulbactam and levofloxacin based on susceptibility testing.
· Emergency fasciotomy and debridement were performed, followed by amputation of the left upper limb to control the spread of infection.
· After intensive care support, including fluid resuscitation and vasopressors, the patient stabilized and eventually recovered without further complications.
Discussion and Implications
The report highlights the deadly potential of V. vulnificus, especially in warmer coastal regions or through contaminated seafood exposure. The case underscores:
· The importance of early clinical recognition and aggressive surgical intervention.
· The utility of rapid diagnostic tools like MALDI-TOF and NGS to identify pathogens and guide treatment.
· The need for public education on safe seafood handling, especially for at-risk populations (e.g., those with liver disease, diabetes, or weakened immunity).
The article also notes that the increasing prevalence of V. vulnificus is likely influenced by global warming, as warmer waters create favorable conditions for the bacteria. Therefore, climate change may expand the geographic range of such infections in the future.
Conclusion
This case study provides a detailed look into the clinical progression, diagnosis, and management of a life-threatening Vibrio vulnificus infection. It reinforces the value of early surgical intervention and advanced diagnostic techniques in improving outcomes. The case also serves as a public health warning regarding food safety and the environmental factors contributing to emerging infectious diseases.