This article analyzed the
medical records of two
patients with
Vibrio vulnificus primary
sepsis who were admitted to the First Affiliated
Hospital of Naval Medical
University and reviewed the latest
literature. On November 6, 2019, a 54-year-old
male patient was admitted to the
hospital. The
patient's
lower limbs were red, swollen, and painful with
ecchymosis and hemorrhagic
bullae after he ate
freshwater products. The
emergency fasciotomy was performed 3 h after admission, and the
multiple organ failure occurred after operation. The
patient was given up
treatment 24 h after admission. On August 12, 2020, a 73-year-old
male patient was admitted to the
hospital. He was in
shock state on admission and had hemorrhagic
bullae on his right
lower limb after he ate
seafood. At 3 h post admission, he underwent
emergency surgical exploration and
amputation of right
thigh. Six days later, he received negative
pressure wound treatment on the stump. On the 13th day post admission, his
families forgo the active
treatment and he died 15 d after admission. The two cases were both failed to be diagnosed at the first
time, and the
disease progressed rapidly.
Necrotizing fasciitis and
multiple organ failure occurred. After the
diagnosis was confirmed, timely
fasciotomy and high
amputation were performed respectively. The microbiological examinations both reported
Vibrio vulnificus. Although the 2 cases were not cured successfully, the
course of
disease and some indexes of
patient with early
amputation were better than those of
patients with
fasciotomy.
Vibrio vulnificus is widely distributed and frequently detected in
fresh water products. The pathogenic pathway is fuzzy and complex, and it is easy to be misdiagnosed. It is necessary to establish the
treatment process of
Vibrio vulnificus sepsis. Early and aggressive surgical intervention should be carried out as soon as possible,
fasciotomy and
debridement should be thorough, and the
patients with hemorrhagic
bullae should be amputated early. Postoperative comprehensive
measures are also important for improving the
survival rate of
patients.