Sepsis and Necrotizing Fasciitis Caused by Vibrio vulnificus in an Old Woman with Cerebral Infarction

 Vibrio vulnificus is a pathogen that usually induces serious infections and even life-threatening diseases. It might delay the diagnosis and targeted treatment of V. vulnificus infection due to early atypical symptoms and low incidence.

 A 73-year-old woman with cerebral infarction developed necrotizing fasciitis with septic infection after admission. The patient developed rapidly progressive symptoms of the right lower limb, nausea and vomiting, hypotension, and liver and kidney function insufficiency on day 10 of hospitalization. Laboratory tests showed a significant increase in infection indicators, and blood cultures showed V. vulnificus growth. Early anti-infective drugs showed a gradual decline in the infection indexes but an aggravation trend in the right lower extremity lesions. The antibiotic regimen was adjusted to cephalosporin combined with quinolones, and local incision decompression and drainage were performed. The patient's infection was controlled, and the local lesion shrank.

 This case report suggests the importance of referring to the results of drug sensitivity and choosing proper antibiotics in consideration of various factors, such as the infected site of the patient and pharmacokinetics/pharmacodynamics (PK/PD) characteristics of antibiotics for V. vulnificus infection. Meanwhile, the timing of surgical intervention is also crucial for the necrotizing fasciitis caused by V. vulnificus.