Clinical manifestations and prognostic factors in Vibrio vulnificus septicemia

Young-Sun Jung,; Sook-In Jung,; Seung-Ji Kang,; Chung Hwan Jun,; Kyung Hwa Park,; Jong Hee Shin,; Eun-Kyeong Chung,

Korean J Med > Volume 74(3); 2008 > Article

Original Article

The Korean Journal of Medicine 2008;74(3):288-295.

Clinical manifestations and prognostic factors in Vibrio vulnificus septicemia

Young-Sun Jung, Sook-In Jung, Seung-Ji Kang, Chung Hwan Jun, Kyung Hwa Park, Jong Hee Shin, Eun-Kyeong Chung

경희대학교 의과대학 순환기내과학교실

원저 : 제 패혈증비브리오균 감염증의 임상양상과 예후인자 분석

정영선 . 정숙인 . 강승지 . 전충환 . 박경화 . 신종희 . 정은경, Sook-In Jung, Seung-Ji Kang, Chung Hwan Jun, Kyung Hwa Park, Jong Hee Shin, Eun-Kyeong Chung

Abstract

Background/Aims : Vibrio vulnificus infection is a common fatal infectious disease in Korea. This study was performed to investigate the clinical manifestations and prognostic factors associated with V. vulnificus infection. Methods : Patients with microbiologically confirmed V. vulnificus infections who were admitted to Chonnam National University Hospital from 2000 to 2005 were enrolled. The epidemiologic characteristics, clinical features, laboratory findings, and prognostic factors were evaluated. Results : Eighty-one patients were enrolled. More than 90% of these patients had various underlying medical conditions such as chronic liver disease or diabetes mellitus. Seventy-one patients (88%) confirmed eating raw fish or exposure to sea water. Characteristic cutaneous lesions were observed in 70 patients (86%). The initial manifestations of the patients without cutaneous lesions were gastrointestinal bleeding (2), peritonitis (2), septicemia (2), acute cholangitis (1), enteritis (1), liver abscess (1), endophthalmitis (1), and hepatic failure (1). The overall case-fatality rate was 65%. Multivariate analysis showed that leukopenia (<4000/mm3) (OR=8.6, 95% CI 1.3～55.2, p=0.023) and medical treatment without surgery (OR=14.7, 95% CI 1.2～172.7, p=0.033) were independent risk factors for mortality among the patients with cutaneous lesions. Conclusions : Although V. vulnificus infection is a still a life-threatening disease in patients with underlying medical conditions, aggressive treatment including surgical intervention is important for the prognosis in patients with vibrio septicemia. (Korean J Med 74:288-295, 2008)

Key Words: Vibrio vulnificus; Prognosis; Surgery