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BMJ Case Rep ; 12(10)2019 Oct 30.
Article in English | MEDLINE | ID: mdl-31666256

ABSTRACT

A 63-year-old woman with a prior history of chronic lower extremity lymphedema came to the hospital for evaluation of new-onset left leg pain and swelling associated with haemorrhagic blisters and foul-smelling discharge. Relevant history included a recent trip to a Hudson River Valley beach in New York 1 week prior to hospitalisation. Laboratory evaluation revealed significant leukocytosis and lactic acidosis. She was found to have sepsis and bacteremia secondary to Vibrio cholerae (serotype non-O1, non-O139). During a prolonged intensive care unit course requiring intravenous pressor support and broad-spectrum antibiotics, she underwent debridement of her left foot eschar along with skin grafting. Once clinically stable and improved, she was discharged to a subacute rehabilitation centre with close follow-up for wound care. V. cholerae infection is rare and often benign but can be transmitted from contaminated seawater to individuals with underlying chronic illness and cause severe symptoms, including sepsis.


Subject(s)
Sepsis/microbiology , Skin Diseases, Infectious/surgery , Vibrio Infections/diagnosis , Vibrio cholerae/isolation & purification , Acidosis, Lactic/diagnosis , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/therapeutic use , Bacteremia/microbiology , Blister/diagnosis , Blister/etiology , Debridement/methods , Diagnosis, Differential , Female , Foot/microbiology , Foot/pathology , Hemorrhage/etiology , Humans , Intensive Care Units , Leukocytosis/diagnosis , Middle Aged , Sepsis/drug therapy , Skin Diseases, Infectious/microbiology , Skin Transplantation/methods , Treatment Outcome , Vasoconstrictor Agents/administration & dosage , Vasoconstrictor Agents/therapeutic use , Vibrio Infections/epidemiology
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