While here in the states there has been a lot of coverage of the two Texas men who contracted very serious Vibrio vulnificus infections in recent weeks, Hong Kong health officials reported two sporadic cases of necrotizing fasciitis since the second week of June.
On June 8 and 11, 2016, the Center for Health Protection (CHP) recorded two cases of necrotizing fasciitis caused by Vibrio vulnificus. The first patient was a 70-yearold man with history of liver cirrhosis. He presented with fever and bilateral leg pain on June 5 and was admitted to a public hospital on the same day. Bilateral lower limb fasciotomy were performed on June 6. The operative diagnosis was necrotizing fasciitis and non-traumatic compartment syndrome. Post-operatively, he was managed in the intensive care unit (ICU) and was treated with antibiotics. He died on June 7. His left leg tissue collected on June 6 subsequently grew Vibrio vulnificus. His home contact was asymptomatic. According to the patient’s home contact, he visited wet market everyday but had no history of injury or contact with seafood.
The second patient was a 53-year-old man with underlying illnesses including liver cirrhosis. He presented with right foot painful swelling on June 6 and was admitted to a public hospital on June 9. He was diagnosed to have necrotizing fasciitis with right above knee amputation done after admission. He was managed in ICU after the operation. His right leg tissue collected on June 10 yielded Vibrio vulnificus. He was treated with antibiotics and remained in stable condition. His home contacts were asymptomatic. The patient had consumed hotpot with oyster during the incubation period. He denied visit to wet market and history of injury.
Vibrio vulnificus can cause disease in those who eat contaminated seafood or have an open wound that is exposed to warm seawater containing the bacteria. Ingestion of Vibrio vulnificus can cause vomiting, diarrhea and abdominal pain. Vibrio vulnificus can also cause an infection of the skin when open wounds are exposed to warm seawater; these infections may lead to skin breakdown and ulcers.
Healthy individuals typically develop a mild disease; however, Vibrio vulnificus infections can be a serious concern for people who have weakened immune systems, particularly those with chronic liver disease.
The bacterium can invade the bloodstream, causing a severe and life-threatening illness with symptoms like fever, chills, decreased blood pressure (septic shock) and blistering skin lesions. Vibrio vulnificus bloodstream infections are fatal about 50 percent of the time. A recent study showed that people with these pre-existing medical conditions were 80 times more likely to develop Vibrio vulnificus bloodstream infections than healthy people.
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