Vibrio vulnificus septic shock due to a contaminated tattoo

BMJ Case Rep. 2017 May 27:2017:bcr2017220199. doi: 10.1136/bcr-2017-220199.

Abstract

We present a case of Vibrio vulnificus septic shock and cellulitis in a patient with chronic liver disease that occurred after obtaining a leg tattoo with subsequent seawater exposure in the Gulf of Mexico. Initial suspicion for V. vulnificus was high and he was started on empiric doxycycline and ceftriaxone at admission. Blood and wound cultures grew oxidase positive and comma-shaped Gram-negative rods ultimately confirmed to be V. vulnificus. Despite aggressive initial treatment, the patient developed septic shock and died. This case highlights the association of chronic liver disease and high mortality associated with infections of V. vulnificus Health providers should remain vigilant for V. vulnificus infections in patients with chronic liver disease and raw oyster ingestion or seawater exposure.

Keywords: Adult intensive care; Cirrhosis; Infections.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Cellulitis / drug therapy
  • Cellulitis / microbiology*
  • Cellulitis / physiopathology
  • Doxycycline / administration & dosage
  • Fatal Outcome
  • Humans
  • Liver Cirrhosis* / complications
  • Male
  • Seawater / microbiology*
  • Shock, Septic / drug therapy
  • Shock, Septic / microbiology*
  • Shock, Septic / physiopathology
  • Swimming
  • Tattooing / adverse effects*
  • Vibrio Infections / drug therapy
  • Vibrio Infections / microbiology*
  • Vibrio Infections / physiopathology
  • Vibrio vulnificus / pathogenicity*

Substances

  • Anti-Bacterial Agents
  • Doxycycline