J Korean Soc Emerg Med.  1999 Jun;10(2):242-249.

The Clinical Study of Vibrio vulnificus Infection Occurred in the Region of the Southwest Coast

• Kim SJ
• Cho NS
• Kim CH
• Kim YB
• Cho SH
• Ahn TH

Abstract

BACKGROUND: V. vulnificus infection is found between May and October when the man who has hepatic disorder or immunity disorder eats raw shellfish and it causes the systemic symptoms such as sudden fever, chilling, shock and stupor and local skin lesions like blob and necrosis. This disease has 46~61% of fatality rate in spite of intensive treatment. This study conducts the examination of history, epidemic study, ingesting raw fish and bacteriologic investigation in the patients with similar clinical symptoms to the above and examines the diagnostic correlations. METHOD: It is conducted with 31 cases who admitted at emergency medical center of Chosun University Hospital from May of 1995 to September of 1998 and are suspected to have V. vulnificus infection. It analyze bacteriologic examination, the survey of residence, eating raw shellfish, hepatic disorder, alcohol drinking habits and skin lesion.
RESULTS
1)the rate of male and female is 15.5:1 and in the age, 18 cases are in fifties, seven ale in fifties and six are over sixties. 2) Clinically, V. vulnificus is detected in 20 of 31 cases which is suspected to have V. vulnificus i18c1ion and it is not detected in 5 cases. Other bacteria are detected in 6 cases and they include staphylococcus aureus, pseudomonas species, beta hemotytic streptococcus and E-coil. 3) In local distribution, Kohung has 10 cases, Shinan and Mokpo have six, Haenam and Kangjin have aye, Yongkwang and Muan have five, Naju and Yongam have five and Kwangju has one. 4) Eating fishes and raw shellfishes is found in 31 cases. In the kind of shellfishes, eating raw clam is 10 cases, raw thin-shelled surf calm is 8 cases, raw oyster is 5 cases and sliced raw fish is 4 cases and pickled sea floods ate 4 cases. 5) The cases with hepatic disorder are 23 and 15 Gases with heavy alcohol dunking Carrier are included. The cases with Diabetic Mellitus are four and those with pulmonary tuberculosis are two. Two cases have not basal diseases. 6) On the opinion of skin lesion, 20 cases show vesicular necrosis, 7 cases have dendriform erythema, 3 cases have papule and one case doesn't show clear skin lesion.
CONCLUSION
When V. vulnificus infection is detected, it is fatal and those who have hepatic disorder or heavy alcohol drinking habit must avoid eating fishes and shellfishes raw in summer. It is important to have emergency treatment for the patient whose V. vulnificus infection is suspected. It is considered that the administration of initial antibiotics is effective by generalizing the clinical symptom, epidemic opinion and patient history even before the results of bacteriologic confirmed.

MeSH Terms

Alcohol Drinking
Anti-Bacterial Agents
Bacteria
Bivalvia
Eating
Emergencies
Emergency Treatment
Erythema
Female
Fever
Fishes
Floods
Gases
Gwangju
Humans
Jeollanam-do
Male
Necrosis
Ostreidae
Pseudomonas
Shellfish
Shock
Skin
Staphylococcus aureus
Streptococcus
Stupor
Tuberculosis, Pulmonary
Vibrio vulnificus*
Vibrio*
Anti-Bacterial Agents
Gases