Clinical manifestations and prognostic factors in Vibrio vulnificus septicemia / 대한내과학회지

ABSTRACT

BACKGROUND/AIMS: Vibrio vulnificus infection is a common fatal infectious disease in Korea. This study was performed to investigate the clinical manifestations and prognostic factors associated with V. vulnificus infection. METHODS: Patients with microbiologically confirmed V. vulnificus infections who were admitted to Chonnam National University Hospital from 2000 to 2005 were enrolled. The epidemiologic characteristics, clinical features, laboratory findings, and prognostic factors were evaluated. RESULTS: Eighty-one patients were enrolled. More than 90% of these patients had various underlying medical conditions such as chronic liver disease or diabetes mellitus. Seventy-one patients (88%) confirmed eating raw fish or exposure to sea water. Characteristic cutaneous lesions were observed in 70 patients (86%). The initial manifestations of the patients without cutaneous lesions were gastrointestinal bleeding (2), peritonitis (2), septicemia (2), acute cholangitis (1), enteritis (1), liver abscess (1), endophthalmitis (1), and hepatic failure (1). The overall case-fatality rate was 65%. Multivariate analysis showed that leukopenia (<4000/mm3) (OR=8.6, 95% CI 1.3~55.2, p=0.023) and medical treatment without surgery (OR=14.7, 95% CI 1.2~172.7, p=0.033) were independent risk factors for mortality among the patients with cutaneous lesions. CONCLUSIONS: Although V. vulnificus infection is a still a life-threatening disease in patients with underlying medical conditions, aggressive treatment including surgical intervention is important for the prognosis in patients with vibrio septicemia.