On February 7, 2017, the Hong Kong Centre for Health Protection (CHP) recorded a sporadic case of necrotizing fasciitis due to Vibrio vulnificus infection affecting a 75-year-old male with underlying illnesses.

Vibrio vulnificus/CDC
Vibrio vulnificus/CDC

He presented with fever and right forearm swelling since January 29. He attended the Accident and Emergency Department of a public hospital on January 30 and was admitted on same day. The clinical diagnosis was necrotizing fasciitis. Excisional debridement of right forearm was performed on January 30 and February 3.

His wound swab culture taken on January 30 grew Vibrio vulnificus. His current condition was stable. Epidemiological investigation revealed that the patient lived with his wife and son who remained asymptomatic. He did not have recent travel history. He did not report any wound or injury. The patient recalled history of buying seafood in a wet market during incubation period. Investigation is ongoing.

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.