Vibrio Vulnificus Infection Treatment & Management
- Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD more...
Antibiotics are necessary to eradicate the infection (see Medication). In case of wound infection, aggressive debridement is necessary to remove necrotic tissue. If the patient is in shock, perform necessary interventions to resuscitate the patient. V vulnificus as the etiologic agent of necrotizing fasciitis requires emergency approaches to treat potential septic shock and multiple organ failure, particularly in those with preexisting medical complications, including hypotension, lactic acidosis, coagulation disorders, and thrombocytopenia.
Available guidelines that may be helpful include the Practice guidelines for the diagnosis and management of skin and soft-tissue infections from the Infectious Diseases Society of America and the Diagnosis and management of foodborne illnesses: a primer for physicians and other health care professionals from the American Medical Association, American Nurses Association, American Nurses Foundation, Centers for Disease Control and Prevention, Center for Food Safety and Applied Nutrition, US Food and Drug Administration, Food Safety and Inspection Service, and US Department of Agriculture.[22, 23]
Because many patients with V vulnificus infection experience overwhelming sepsis, consultation with an infectious disease specialist is warranted. Consider consultation with an infectious disease specialist if the diagnosis is unclear or if the patient has atypical symptoms or does not respond to antibiotic treatment.
No restrictions are necessary.
Patients who are immunocompromised are at risk of septic shock from the infection, which can be fatal. Otherwise, no complications from V vulnificus infection occur.
To prevent infection from V vulnificus, persons should avoid exposure to raw shellfish or thoroughly cook the shellfish. Persons should avoid cross-contamination of cooked shellfish with uncooked shellfish and eat shellfish promptly after cooking. Shellfish is best served hot.
Identifying oysters that are affected by V vulnificus is difficult because the appearance, taste, color, and odor of the oysters are not affected. Through improved reporting of affected oysters, oyster beds that are affected can be identified and closed.
Persons should avoid exposure of open wounds or broken skin to raw shellfish or infected waters. Patients who are immunocompromised should be especially careful to follow these guidelines because they are more susceptible to infection and complications.
Therapeutic vaccination against V vulnificus infection by active and passive immunization with the C-terminal region of the RtxA1/MARTXVv protein has been suggested by studies in mice.
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