Major associations between septicemia from V. vulnificus

Q: 48 years old male, considered a 'party animal' by his friends, is brought to a New York City Emergency Department with septicemia. Friends also give history of consumption of raw seafood and binge drinking while parting till late at night. The party was arranged as the weather suddenly became warm in the city after a winter storm. The patient is diagnosed with Vibrio vulnificus. Which of the following seafood has been reported to have the highest association with V. vulnificus? - Select one

A) Oysters

B) Salmon fish

C) Tilapia fish

D) Shelled Shrimp

E) Alaska Pollock

Answer: A

The objective of the above question (if you read again!) is to identify the three major associations between septicemia and V. vulnificus.

1. raw or undercooked seafood 

2, increased weather temperatures 

3. underlying alcoholic сirrhоsiѕ 

Although traditionally considered a disease of Gulf Coast states in the United States (particularly after floods and hurricanes), more and more northern states report such cases yearly.

Raw or undercooked seafood (primarily oysters) has been reported as the most commonly associated seafood.

The most commonly underlying associated disease was found to be alcoholic сirrhоsiѕ, followed by underlying liver diseases such as chronic hepatitis (alcoholic or other). It has also been reported that those who do not have underlying hepatic disease report moderate to heavy alcohol use. Other associated conditions are:

• Hereditary hemochromatosis
• Diаbеtеs mellitus
• Thalassemia
• Chronic renal failure
• Rheumatoid arthritis
• Cancer
• Lymphoma
• Immunocompromised state

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#epidemiology

References:

1. Nigro OD, James-Davis LI, De Carlo EH, et al. Variable Freshwater Influences on the Abundance of Vibrio vulnificus in a Tropical Urban Estuary. Appl Environ Microbiol 2022; 88:e0188421.

2. King M, Rose L, Fraimow H, et al. Vibrio vulnificus Infections From a Previously Nonendemic Area. Ann Intern Med 2019; 171:520.

3. Dechet AM, Yu PA, Koram N, Painter J. Nonfoodborne Vibrio infections: an important cause of morbidity and mortality in the United States, 1997-2006. Clin Infect Dis 2008; 46:970.

4. Jones MK, Oliver JD. Vibrio vulnificus: disease and pathogenesis. Infect Immun 2009; 77:1723.