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Vibrio vulnificus septicemia and necrotizing fasciitis in the patients with liver cirrhosis and diabetes mellitus

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DOI: 10.4236/jdm.2012.21020    4,674 Downloads   8,091 Views   Citations

ABSTRACT

Vibrio vulnificus (V. vulnificus) infection is a rare disease in Japan but the leading cause of death related to raw seafood consumption. We hereby reported a successfully treated case of V. vulnificus septicemia, severe necrotizing fasciitis, disseminated intravascular coagulation and multiple organ failure after raw perch consumption with underlying alcoholic liver cirrhosis and diabetes mellitus. It is the first report of a case of V. vulnificusinfection caused by eating raw perch, whereas V. vulnificus infection should be suspected in all of middle-aged to elderly men with underlying immunosuppressive diseases, who have recent consumption of raw seafood or contact with seawater, especially in the summer. The levels of HbA1c and glycoalbumin were not high in the present case, however, obvious hyperglycemia was found even after the infection had completely healed. On reviewing 166 case of V. vulnificus infection in Japan including ours, the complication of diabetes mellitus, one of immunocompromised condition, was found only in 11%, although it had been reported that individuals strongly suspected of having diabetes were 17.2% among the Japanese male population aged from 40 to 74 years. Because diabetes mellitus might be underdiagnosed in the previous reports, intensive examinations are considered to be necessary in order to correctly diagnose diabetes mellitus in patients with severe V. vulnificus infection.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Ito, H. , Shibayama, A. , Abe, M. , Antoku, S. , Nawata, H. , Isonishi, M. , Fujita, M. and Kato, S. (2012) Vibrio vulnificus septicemia and necrotizing fasciitis in the patients with liver cirrhosis and diabetes mellitus. Journal of Diabetes Mellitus, 2, 122-125. doi: 10.4236/jdm.2012.21020.

References

[1] Klontz, K.C., Lieb, S., Schreiber, M., Janowski, H.T., Baldy, L.M. and Gunn, R.A. (1988) Syndromes of Vibrio vulnificus infections. Clinical and epidemiologic features in Florida cases, 1981-1987. Annals of Intern Medicine, 109, 318-323.
[2] Tacket, C.O., Brenner, F. and Blake, P.A. (1984) Clinical features and an epidemiological study of Vibrio vulnificus infections. The Journal of Infectious Diseases, 149, 558-561. doi:10.1093/infdis/149.4.558
[3] Miya, H. (1978) Fulminating lactose-positive Vibrio septicemia. Acta Pathologica Japonica, 28, 937-948.
[4] Seino, Y., Nanjo, K., Tajima, N., Kadowaki, T., Kashiwagi, A., et al. (2010) Report of the Committee on the Classification and Diagnostic Criteria of Diabetes Mellitus. Journal of Diabetes Invest, 1, 213-228.
[5] Singh, G., Sinha, S.K., Adhikary, S., Babu, K.S., Ray, P. and Khanna, S.K. (2002) Necrotising infections of soft tissues—A clinical profile. The European Journal of Surgery, 168, 366-371. doi:10.1080/11024150260284897
[6] Elliott, D.C., Kufera, J.A. and Myers, R.A. (1996) Necrotizing soft tissue infections. Risk factors for mortality and strategies for management. Annals of Surgery, 224, 672-683. doi:10.1097/00000658-199611000-00011
[7] Harwood, V.J., Gandhi, J.P. and Wright, A.C. (2004) Methods for isolation and confirmation of Vibrio vulnificus from oysters and environmental sources: A review. Journal of Microbiological Methods, 59, 301-316. doi:10.1016/j.mimet.2004.08.001
[8] Inoue, Y., Ono, T., Matsui, T., Miyasaka, J., Kinoshita, Y. and Ihn, H. (2008) Epidemiological survey of Vibrio vulnificus infection in Japan between 1999 and 2003. The Journal of Dermatology, 35, 129-139. doi:10.1111/j.1346-8138.2008.00432.x
[9] Kikawa, K., Yamasaki, K., Sujiura, T., Myose, H., Chinen, M., Tsutsumi, K., Iwao, N. and Dohzono, T. (1990) A successfully treated case of Vibrio vulnificus septicemia with shock. Japanese Journal of Medicine, 29, 313-319. doi:10.2169/internalmedicine1962.29.313
[10] Nakafusa, J., Misago, N., Miura, Y., Kayaba, M., Tanaka, T. and Narisawa, Y. (2001) The importance of serum creatine phosphokinase level in the early diagnosis, and as a prognostic factor, of Vibrio vulnificus infection. The British Journal of Dermatology, 145, 280-228. doi:10.1046/j.1365-2133.2001.04347.x
[11] Tajiri, T., Tate, G., Akita, H., Ohike, N., Masunaga, A., Kunimura, T., Mitsuya, T. and Morohoshi, T. (2008) Autopsy cases of fulminant-type bacterial infection with necrotizing fasciitis: Group A (beta) hemolytic Streptococcus pyogenes versus Vibrio vulnificus infection. Pathology International, 58, 196-202. doi:10.1111/j.1440-1827.2007.02211.x
[12] Inoue, H. (2006) Vibrio vulnificus infection of the hand. Journal of Orthopaedic Science, 11, 85-87. doi:10.1007/s00776-005-0965-x
[13] Ikeda, T., Kanehara, S., Ohtani, T. and Furukawa, F. (2006) Endotoxin shock due to Vibrio vulnificus infection. European Journal Dermatology, 16, 423-427.
[14] Chen, Y., Satoh, T., Tokunaga, O. (2002) Vibrio vulnificus infection in patients with liver disease: Report of five autopsy cases. Virchows Archiv, 441, 88-92. doi:10.1007/s00428-002-0613-1
[15] The Ministry of Health, Labour and Welfare of Japan (2008) http://www.mhlw.go.jp/houdou/2008/12/dl/h1225-5d.pdf
[16] Davies, H.D., McGeer, A., Schwartz, B., Green, K., Cann, D., Simor, A.E. and Low, D.E. (1996) Invasive group A streptococcal infections in Ontario, Canada. Ontario Group A Streptococcal Study Group. The New England Journal of Medicine, 335, 547-554. doi:10.1056/NEJM199608223350803
[17] Blake, P.A., Merson, M.H., Weaver, R.E., Hollis, D.G. and Heublein, P.C. (1979) Disease caused by a marine Vibrio. Clinical characteristics and epidemiology. The New England Journal of Medicine, 300, 1-5. doi:10.1056/NEJM197901043000101

  
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