Vibrio vulnificus infection complicated by acute respiratory distress syndrome in a child with nephrotic syndrome

A 9‐year‐old girl with nephrotic syndrome visited a local hospital after developing fever, chills, and edematous changes and multiple hemorrhagic bullae on both legs over 2 days. Cultures of blood and an aspirate from the bullae yielded Vibrio vulnificus. The patient was transferred to our hospital because of persistent fever, generalized edema, acute renal failure, and disseminated intravascular coagulopathy. We treated this patient as a V. vulnificus infection complicated with necrotizing fasciitis. With minocycline and ceftazidime combination therapy was instituted. Emergency fasciotomy and continuous peritoneal dialysis were performed.

[1]  J. Vallejo,et al.  Vibrio vulnificus sepsis in a child with Diamond-Blackfan syndrome. , 1997, The Pediatric infectious disease journal.

[2]  K. Ooe Pulmonary damage by Vibrio vulnificus cytolysin , 1997, Infection and Immunity.

[3]  Fontenelle Lj,et al.  Primary skin infections secondary to Vibrio vulnificus: the role of operative intervention. , 1996 .

[4]  B. Park,et al.  Pulmonary damage by Vibrio vulnificus cytolysin , 1996, Infection and immunity.

[5]  E. Biosca,et al.  Toxic and enzymatic activities of Vibrio vulnificus biotype 2 with respect to host specificity , 1996, Applied and environmental microbiology.

[6]  M. Marsh,et al.  Lesson of the Week: Nephrotic syndrome in childhood complicated by life threatening pulmonary oedema , 1996, BMJ.

[7]  M. Kollef,et al.  The acute respiratory distress syndrome. , 1995, The New England journal of medicine.

[8]  L. Lavery,et al.  Lower extremity manifestations of Vibrio vulnificus infection. , 1995, Journal of Foot and Ankle Surgery.

[9]  K. Latta,et al.  Nephrosis in childhood. , 1995, Nephron.

[10]  C. Pc,et al.  Vibrio vulnificus infection--report of 8 cases and review of cases in Taiwan. , 1994 .

[11]  S. Miyoshi,et al.  Vibrio vulnificus may produce a metalloprotease causing an edematous skin lesion in vivo. , 1994, FEMS microbiology letters.

[12]  A. E. Toranzo,et al.  Role of iron, capsule, and toxins in the pathogenicity of Vibrio vulnificus biotype 2 for mice , 1994, Infection and immunity.

[13]  E. Warnock,et al.  Primary Vibrio vulnificus septicemia. , 1993, The Journal of emergency medicine.

[14]  Y. Chuang,et al.  Vibrio vulnificus infection in Taiwan: report of 28 cases and review of clinical manifestations and treatment. , 1992, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[15]  J. Morris,et al.  The extracellular cytolysin of Vibrio vulnificus: inactivation and relationship to virulence in mice , 1991, Infection and immunity.

[16]  G. French,et al.  Vibrio vulnificus septicaemia presenting as spontaneous necrotising cellulitis in a woman with hepatic cirrhosis. , 1989, Scandinavian journal of infectious diseases.

[17]  Y. Chuang,et al.  Vibrio vulnificus infection. , 1989, Scandinavian journal of infectious diseases.

[18]  B. Katz Vibrio vulnificus meningitis in a boy with thalassemia after eating raw oysters. , 1988, Pediatrics.

[19]  K. Klontz,et al.  Syndromes of Vibrio vulnificus infections. Clinical and epidemiologic features in Florida cases, 1981-1987. , 1988, Annals of internal medicine.

[20]  A. Kreger,et al.  Mouse skin damage caused by cytolysin from Vibrio vulnificus and by V. vulnificus infection. , 1987, The Journal of infectious diseases.

[21]  M. Weil,et al.  Absence of lung edema in nephrotic rats. , 1986, Journal of Laboratory and Clinical Medicine.

[22]  G. French,et al.  Necrotising fasciitis caused by Vibrio vulnificus. , 1984, Journal of clinical pathology.

[23]  C. Tacket,et al.  Wound infections caused by Vibrio vulnificus, a marine vibrio, in inland areas of the United States , 1984, Journal of clinical microbiology.

[24]  J. Farmer VIBRIO ("BENECKEA") VULNIFICUS, THE BACTERIUM ASSOCIATED WITH SEPSIS, SEPTICÆMIA, AND THE SEA , 1979, The Lancet.

[25]  A. Bauer,et al.  Antibiotic susceptibility testing by a standardized single disk method. , 1966, American journal of clinical pathology.

[26]  Wright Gp Histology of typical lesions after streptomycin. , 1947 .