Severe septicemia, necrotizing fasciitis, and peritonitis due to Vibrio vulnificus in a patient undergoing continuous ambulatory peritoneal dialysis: a case report

BMC Infectious Diseases

Case Report

Chang Seong Kim¹  Soo Wan Kim¹  Seong Kwon Ma¹  Eun Hui Bae¹ 

[1]Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, 501-757, Gwangju, South Korea

关键词: Vibrio vulnificus;    Septicemia;    Peritonitis;    Necrotizing fasciitis;    Peritoneal dialysis;   

DOI  :  10.1186/s12879-015-1163-x

 received in 2015-07-14, accepted in 2015-10-01,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundChronic kidney disease, including end-stage renal disease, has been identified as a possible risk factor for primary septicemia and wound infection by Vibrio vulnificus. However, cases of severe septicemia, necrotizing fasciitis, and peritonitis caused by V. vulnificus in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) have not been described. We report a case of severe septicemia, necrotizing fasciitis, and peritonitis due to V. vulnificus in a patient undergoing CAPD after ingesting raw seafood.Case presentationA 37-year-old woman undergoing CAPD was admitted to the emergency room due to general weakness, fever, diarrhea, and abdominal pain. Although empirical intraperitoneal antibiotics were administered for the diagnosis of CAPD-related peritonitis, her fever did not subside. On hospital day 3, she had hemorrhagic bullae on both lower legs. We evaluated her recent food history, and found that she ate raw seafood before admission. She underwent emergency fasciotomy on the suspicion of necrotizing fasciitis by V. vulnificus infection. Finally, V. vulnificus was confirmed by 16S ribosomal ribonucleic acid gene sequencing using blood and peritoneal effluent fluid cultures. The administration of intraperitoneal ceftazidime and intravenous ciprofloxacin/ceftriaxone was continued for 4 weeks, and the patient completely recovered.ConclusionsSuspicion of V. vulnificus infection in vulnerable patients who ingest raw seafood is essential for prompt diagnosis, which could significantly improve patient outcomes.

【 授权许可】

CC BY   
© Kim et al. 2015