Vibrio vulnificus wound infections from the Mississippi Gulf coastal waters: June to August 1993.

Vibrio vulnificus, part of the normal marine flora of the Gulf of Mexico, is being increasingly recognized as an important human pathogen. V vulnificus contamination of superficial wounds can cause a severe, rapidly progressive, necrotizing cellulitis with bullous skin lesions that may require surgical debridement and is occasionally fatal. We summarize information about six cases of V vulnificus wound infection reported to the Mississippi State Department of Health from June to August 1993. Five of the six patients required hospitalization for intravenous antibiotic treatment and, in two cases, surgery. Two patients died from septicemia, despite aggressive antibiotic treatment; both had preexisting medical conditions that could have contributed to immune compromise and fulminant infection. This report underscores the virulence of this organism and the need for awareness by both the clinician and diagnostic laboratory personnel when dealing with superficial wounds occupationally or recreationally exposed to seawater.

The reliability of excretory urography as a screening examination for blunt renal trauma.

A prospective study was designed to evaluate the reliability of excretory urography (EU) in excluding renal damage in patients with blunt abdominal trauma, using contrast-enhanced computed tomography (CECT) as the "gold standard" of diagnostic studies. Sixty patients with indications for genitourinary evaluation and with normal EU underwent CECT. Five renal injuries were demonstrated by CECT in patients with negative EU: one contusion, one subcapsular hematoma, two perirenal hematomas, and one renal laceration. All of these lesions resolved with conservative patient management. Thus, the CECT findings did not alter treatment in these five patients.