The FP suspected a Vibrio vulnificus infection secondary to ingesting the raw oysters, especially because the patient had a history of liver disease. V vulnificus grew out of the patient’s blood cultures, confirming the diagnosis.
V vulnificus is a free-living bacterium that is found in warm saltwater, such as in the Gulf of Mexico. This patient had been visiting the Gulf Coast when he ate the raw oysters. V vulnificus becomes concentrated in filter-feeding shellfish such as oysters.
Eating raw oysters can lead to overwhelming infections from V vulnificus, especially in those with liver disease, lymphoma, leukemia, and diabetes. The mortality rate in people with primary V vulnificus sepsis exceeds 40%.1
Unfortunately, the patient’s liver disease predisposed him to a more serious infection. Despite appropriate use of systemic antibiotics and supportive care, the patient died from sepsis.
1. Falcon LM, Pham L. Images in clinical medicine. Hemorrhagic cellulitis after consumption of raw oysters. N Engl J Med. 2005;353:1604.
Photo courtesy of Donna Nguyen, MD. Text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Usatine R. Cellulitis. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:693-697.
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