Syndromes of Vibrio vulnificus infections. Clinical and epidemiologic features in Florida cases, 1981-1987.

STUDY OBJECTIVE: To describe the clinical and epidemiologic features of Vibrio vulnificus infections.

DESIGN: Case series based on notifiable disease report forms and patient medical records.

SETTING: Cases reported to the Florida Department of Health and Rehabilitative Services from 1981 to 1987.

PATIENTS: Sixty-two patients with V. vulnificus infection.

MEASUREMENTS AND MAIN RESULTS: The three clinical syndromes found were primary septicemia (38 patients), wound infections (17 patients), and gastrointestinal illness without septicemia or wound infections (7 patients). Mortality rate was highest for patients with primary septicemia (55%; 95% CI, 38 to 71) and intermediate for wound infections (24%; 95% CI, 8 to 51): no deaths occurred in those with gastrointestinal illness. Common characteristics and exposures in patients with these syndromes included recent history of raw oyster consumption for primary septicemia and gastrointestinal illness, liver disease for primary septicemia, and either having a preexisting wound or sustaining a wound in contact with seawater for wound infections.

CONCLUSIONS: Clinicians should ask about marine exposures in patients with underlying medical conditions, especially liver disease, who present with unexplained febrile illness, and should start appropriate therapy promptly.