Comments
INITIAL SYMPTOMS:
Wound infections (cellulitis) in oyster shuckers or fishermen; Septicemia and metastatic skin lesions (vesicles and bullae) in an immunocompromised patient 1-3 days after eating raw oysters; [PPID]
Vibrio vulnificus causes skin infections in normal hosts. It causes septic shock and bullous skin lesions in immunocompromised hosts, including patients with chronic liver disease and hemochromatosis. Wounds may become infected after contact with contaminated water, leading to cellulitis and myositis (can mimic clostridial myonecrosis). [CCDM, p. 111] Wound infections occur after cleaning fish, shelling crabs, or shucking oysters. The organisms grow in warm seawater (greater than 60 degrees F). Susceptible patients include those with cirrhosis, hemochromatosis, thalassemia, AIDS, diabetes, chronic renal failure, and malignancy. Eating undercooked seafood contaminated with Vibrio vulnificus can result in sepsis and shock in these immunocompromised patients. Septic arthritis is a rare complication. [ID, p. 667; PPID, p. 2481-2] The mortality rate is about 50%. [Harrison ID, p. 590] Streptococcus iniae cellulitis occurs in fish farmers, fish cutters, and cooks exposed to tilapia with complications including septic arthritis, meningitis, and endocarditis. [PPID, p. 1207] See "Cellulitis" for other fish-related skin infections.
For updated text and symptoms of infectious diseases, see iddx.com.