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Vibrio vulnificus is a species of Gram-negative, motile, curved, rod-shaped (bacillus), pathogenic bacteria of the genus Vibrio. Present in marine environments such as estuaries, brackish ponds, or coastal areas, V. vulnificus is related to V. cholerae, the causative agent of cholera. Infection with V. vulnificus leads to rapidly expanding cellulitis or septicemia. It was first isolated as a source of disease in 1976. The capsule, made of polysaccharides, is thought to protect against phagocytosis. The observed association of the infection with liver disease (associated with increased serum iron) might be due to the capability of more virulent strains to capture iron bound to transferrin. Toxin production plays a relevant role in pathogenicity.

Signs and symptoms

V. vulnificus is an extremely virulent bacterium that can cause three types of infections:

  • Acute gastroenteritis from eating raw or undercooked shellfish: V. vulnificus causes an infection often incurred after eating seafood, especially raw or undercooked oysters. It does not alter the appearance, taste, or odor of oysters. Symptoms include vomiting, explosive diarrhea and abdominal pain
  • Necrotizing wound infections can occur in injured skin exposed to contaminated marine water. V. vulnificus bacteria can enter the body through open wounds when swimming or wading in infected waters, or by puncture wounds from the spines of fish such as tilapia or stingrays. These patients may develop a blistering dermatitis sometimes mistaken for pemphigus or pemphigoid.
  • Invasive septicemia can occur after eating raw or undercooked shellfish, especially oysters. V. vulnificus is 80 times more likely to spread into the bloodstream in people with compromised immune systems, especially those with chronic liver disease. When this happens, severe symptoms including blistering skin lesions and septic shock can sometimes lead to death. This severe infection may occur regardless of whether the infection began from contaminated food or an open wound.

Among healthy people, ingestion of V. vulnificus can cause vomiting, diarrhea, and abdominal pain. In someone with a compromised immune system, particularly those with chronic liver disease, it can infect the bloodstream, causing a severe and life-threatening illness characterized by fever and chills, decreased blood pressure (septic shock), and blistering skin lesions.

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