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Vibrio Cellulitis

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21. Vibrio Infections (Overview)

with Vibrio infections die because of the high mortality rate (35-50%) associated with V vulnificus septicemia. Among all foodborne diseases, V vulnificus infection is associated with the highest case fatality rate (39%). Patients with who consumed raw oysters were 80 times more likely to develop V vulnificus infection and 200 times more likely to die of the infection than those without liver disease who consumed raw oysters. [ ] A 2017 case study reported V vulnificus cellulitis in a patient (...) Vibrio Infections (Overview) Vibrio Infections: Background, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjMyMDM4LW92ZXJ2aWV3 processing > Vibrio Infections Updated: Jul 24, 2018

2014 eMedicine.com

22. Cellulitis

may result in cellulitis; Pasteurella multocida is the cause in cat bites, and Capnocytophaga sp is responsible in dog bites. Immersion injuries in fresh water may result in cellulitis caused by Aeromonas hydrophila ; in warm salt water, by Vibrio vulnificus (see ). Immunocompromised patients may become infected by opportunistic organisms, including gram-negative bacteria (such as Proteus, Serratia, Enterobacter, or Citrobacter —see ), , and Helicobacter (see ) and Fusarium spp (see ). may rarely (...) and ceftazidime or a fluoroquinolone. Cellulitis caused by exposure to fresh water should be treated with ceftazidime , cefepime , or a fluoroquinolone. Likely infecting organisms tend to be similar in brackish and fresh water (eg, Vibrio sp, Aeromonas sp, Shewanella sp, Erysipelothrix rhusiopathiae , Mycobacterium marinum , Streptococcus iniae ). Untreated tinea pedis can predispose patients to recurrent lower extremity bacterial cellulitis; treating the fungal infection eliminates the nidus of bacteria

2013 Merck Manual (19th Edition)

23. Necrotising fasciitis

BJ, Potyondy LD, Nachreiner R, et al. Necrotizing fasciitis: a fourteen-year retrospective study of 163 consecutive patients. Am Surg. 2002 Feb;68(2):109-16. http://www.ncbi.nlm.nih.gov/pubmed/11842952?tool=bestpractice.com Hasham S, Matteucci P, Stanley PR, et al. Necrotising fasciitis. BMJ. 2005 Apr 9;330(7495):830-3. [Erratum in: BMJ. 2005 May 14;330(7500):1143.] http://www.ncbi.nlm.nih.gov/pubmed/15817551?tool=bestpractice.com Pasternack MS, Swartz MN. Cellulitis, necrotizing fasciitis (...) , Nachreiner R, et al. Necrotizing fasciitis: a fourteen-year retrospective study of 163 consecutive patients. Am Surg. 2002 Feb;68(2):109-16. http://www.ncbi.nlm.nih.gov/pubmed/11842952?tool=bestpractice.com Hasham S, Matteucci P, Stanley PR, et al. Necrotising fasciitis. BMJ. 2005 Apr 9;330(7495):830-3. [Erratum in: BMJ. 2005 May 14;330(7500):1143.] http://www.ncbi.nlm.nih.gov/pubmed/15817551?tool=bestpractice.com Pasternack MS, Swartz MN. Cellulitis, necrotizing fasciitis, and subcutaneous tissue

2018 BMJ Best Practice

24. Timing of Operative Debridement for Necrotizing Soft Tissue

. The clinical manifestations range from pyoderma to necrotizing cellulitis, myositis, progressive bacterial synergistic gangrene, and life-threatening necrotizing fasciitis. [ ] Necrotizing soft tissue infections are commonly seen in the extremities and abdominal walls, although any part of the body can be affected. Fournier gangrene, for example, is a fulminant form of NSTI that involves the perineal, genital, or perianal regions in men. Even though there are several definitions and classification systems (...) by Group A β-hemolytic streptococci, especially the toxin producing strains of S. pyogenes . Other less common organisms include Vibrio vulnificus (Type III NSTI), which is found in marine environments; Aeromonas hydrophila , found in fresh or brackish water; and Clostridium perfringens . [ ] Polymicrobial infections account for the majority of infections and involve a combination of bacteria, including Staphylococcal , Streptococcal species, Escherichia coli , Bacteroides fragilis, or Clostridium

2018 Eastern Association for the Surgery of Trauma

26. CRACKCast E137 – Skin Infections

Erysipelas Cause: Strep (most common Strep Pyogenes) Tx: Penicillin, Macrolide, Clinda Salt Water : Vibrio Vulnificus Fresh Water : Aeromonas Tx: Keflex + Cipro Indications for antibiotics in abscess Comorbidities Immunosuppression Systemically unwell Shock / Hemodynamic instability Associated cellulitis (>5cm) Multiple foci of infection Difficult area to drain Failure of response to I & D Impetigo Non-Bullous Aureus Pyogens MRSA Bullous Aureus MRSA Treatment Hygiene Topical mupirocin Keflex MRSA (...) of cellulitis suggest agents effective against streptococci and methicillin-sensitive Staphylococcus aureus (eg, cephalexin at maximal doses). Adjunctive measures are essential to a good treatment response—NSAIDs, immobilization, elevation, and compression. Clindamycin monotherapy is an excellent choice for the treatment of skin infections because it covers streptococci and most staphylococci, including most CA-MRSA isolates. (not so excellent in our settings!) Although they are active against CA-MRSA

2017 CandiEM

28. Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections (Full text)

and drainage plus oral antibiotics or those with systemic signs of infection such as temperature >38°C, tachycardia (heart rate >90 beats per minute), tachypnea (respiratory rate >24 breaths per minute) or abnormal white blood cell count (<12 000 or <400 cells/µL), or immunocompromised patients. Nonpurulent SSTIs. Mild infection: typical cellulitis/erysipelas with no focus of purulence. Moderate infection: typical cellulitis/erysipelas with systemic signs of infection. Severe infection: patients who have (...) and drainage plus oral antibiotics or those with systemic signs of infection such as temperature >38°C, tachycardia (heart rate >90 beats per minute), tachypnea (respiratory rate >24 breaths per minute) or abnormal white blood cell count (<12 000 or <400 cells/µL), or immunocompromised patients. Nonpurulent SSTIs. Mild infection: typical cellulitis/erysipelas with no focus of purulence. Moderate infection: typical cellulitis/erysipelas with systemic signs of infection. Severe infection: patients who have

2014 Infectious Diseases Society of America PubMed

30. Yersinia Enterocolitica (Diagnosis)

, preliminarily identified a total of 19,089 laboratory-confirmed cases of infection caused by bacterial pathogens that are commonly transmitted through food. The number of cases and incidence per 100,000 population were reported as follows [ ] : Salmonella (8256; 17.6) Campylobacter (6365; 13.6) Shigella (1780; 3.8) Shiga toxin-producing E coli (STEC) non-O157 (451; 1.0) STEC O157 (442; 0.9) Vibrio (193; 0.4) Yersinia (159; 0.3) Listeria (125; 0.3) In the United States, Yersinia enterocolitica accounts (...) cellulitis and ulcerative conjunctivitis caused by Yersinia enterocolitica O:8. Ophthal Plast Reconstr Surg . 2008 Sep-Oct. 24(5):425-6. . Tennant SM, Hartland EL, Phumoonna T, Lyras D, Rood JI, Robins-Browne RM, et al. Influence of gastric acid on susceptibility to infection with ingested bacterial pathogens. Infect Immun . 2008 Feb. 76(2):639-45. . . Lamps LW, Madhusudhan KT, Greenson JK, Pierce RH, Massoll NA, Chiles MC, et al. The role of Yersinia enterocolitica and Yersinia pseudotuberculosis

2014 eMedicine.com

31. Food Poisoning (Diagnosis)

food poisoning should focus on assessing the severity of dehydration. General findings may include the following: Mild dehydration: A dry mouth, decreased axillary sweat, decreased urine More severe volume depletion: Orthostasis, tachycardia, hypotension Salmonella typhi infection: Upper abdominal rose spot macules, hepatosplenomegaly Yersinia infection: Erythema nodosum, exudative pharyngitis Vibrio vulnificus or V alginolyticus infection: cellulitis, otitis media Always perform a rectal (...) with noninflammatory diarrhea because of smaller stool volumes. Fecal leukocytes or a positive stool lactoferrin test indicates an inflammatory process, and sheets of leukocytes indicate colitis. Sometimes, the organisms penetrate the mucosa and proliferate in the local lymphatic tissue, followed by systemic dissemination. Examples include , Vibrio parahaemolyticus, enterohemorrhagic and enteroinvasive , Yersinia enterocolitica, , , and and species. In some types of food poisoning (eg, staphylococci, B cereus

2014 eMedicine.com

32. Food Poisoning (Overview)

food poisoning should focus on assessing the severity of dehydration. General findings may include the following: Mild dehydration: A dry mouth, decreased axillary sweat, decreased urine More severe volume depletion: Orthostasis, tachycardia, hypotension Salmonella typhi infection: Upper abdominal rose spot macules, hepatosplenomegaly Yersinia infection: Erythema nodosum, exudative pharyngitis Vibrio vulnificus or V alginolyticus infection: cellulitis, otitis media Always perform a rectal (...) with noninflammatory diarrhea because of smaller stool volumes. Fecal leukocytes or a positive stool lactoferrin test indicates an inflammatory process, and sheets of leukocytes indicate colitis. Sometimes, the organisms penetrate the mucosa and proliferate in the local lymphatic tissue, followed by systemic dissemination. Examples include , Vibrio parahaemolyticus, enterohemorrhagic and enteroinvasive , Yersinia enterocolitica, , , and and species. In some types of food poisoning (eg, staphylococci, B cereus

2014 eMedicine.com

33. Yersinia Enterocolitica (Overview)

of 19,089 laboratory-confirmed cases of infection caused by bacterial pathogens that are commonly transmitted through food. The number of cases and incidence per 100,000 population were reported as follows [ ] : Salmonella (8256; 17.6) Campylobacter (6365; 13.6) Shigella (1780; 3.8) Shiga toxin-producing E coli (STEC) non-O157 (451; 1.0) STEC O157 (442; 0.9) Vibrio (193; 0.4) Yersinia (159; 0.3) Listeria (125; 0.3) In the United States, Yersinia enterocolitica accounts for approximately 5% of bacterial (...) cellulitis and ulcerative conjunctivitis caused by Yersinia enterocolitica O:8. Ophthal Plast Reconstr Surg . 2008 Sep-Oct. 24(5):425-6. . Tennant SM, Hartland EL, Phumoonna T, Lyras D, Rood JI, Robins-Browne RM, et al. Influence of gastric acid on susceptibility to infection with ingested bacterial pathogens. Infect Immun . 2008 Feb. 76(2):639-45. . . Lamps LW, Madhusudhan KT, Greenson JK, Pierce RH, Massoll NA, Chiles MC, et al. The role of Yersinia enterocolitica and Yersinia pseudotuberculosis

2014 eMedicine.com

34. Infections in the Immunocompromised Host (Diagnosis)

species. Asplenia (congenital or acquired) predisposes patients to malaria, babesiosis, and infection by encapsulated organisms, including the following: S pneumoniae, H influenzae, E coli, K pneumoniae, Neisseria meningitidis, and Capnocytophaga canimorsus . [ ] Iron overload predisposes patients to Yersinia, Vibrio, and Capnocytophaga infections. Leukemia or lymphoma predisposes patients to infections with S aureus, coagulase-negative staphylococci, P aeruginosa, enteric organisms, fungi [ ] , S (...) , Vibrio vulnificans, Aeromonas species Metabolic complications - S aureus infection, candidiasis, mucormycosis Pregnancy complications - S agalactiae, Candida species, Listeria species, hepatitis E virus Pulmonary complications Asthma predisposes patients to invasive pneumococcal infections. Asthma and atopy predispose to viral infections (rhinovirus) [ ] CF predisposes to infections with S aureus, H influenzae, P aeruginosa (mucoid in CF), S marcescens, B cepacia, Stenotrophomonas maltophilia

2014 eMedicine Pediatrics

35. Infections in the Immunocompromised Host (Overview)

species. Asplenia (congenital or acquired) predisposes patients to malaria, babesiosis, and infection by encapsulated organisms, including the following: S pneumoniae, H influenzae, E coli, K pneumoniae, Neisseria meningitidis, and Capnocytophaga canimorsus . [ ] Iron overload predisposes patients to Yersinia, Vibrio, and Capnocytophaga infections. Leukemia or lymphoma predisposes patients to infections with S aureus, coagulase-negative staphylococci, P aeruginosa, enteric organisms, fungi [ ] , S (...) , Vibrio vulnificans, Aeromonas species Metabolic complications - S aureus infection, candidiasis, mucormycosis Pregnancy complications - S agalactiae, Candida species, Listeria species, hepatitis E virus Pulmonary complications Asthma predisposes patients to invasive pneumococcal infections. Asthma and atopy predispose to viral infections (rhinovirus) [ ] CF predisposes to infections with S aureus, H influenzae, P aeruginosa (mucoid in CF), S marcescens, B cepacia, Stenotrophomonas maltophilia

2014 eMedicine Pediatrics

36. Yersinia Enterocolitica Infection (Overview)

, preliminarily identified a total of 19,089 laboratory-confirmed cases of infection caused by bacterial pathogens that are commonly transmitted through food. The number of cases and incidence per 100,000 population were reported as follows [ ] : Salmonella (8256; 17.6) Campylobacter (6365; 13.6) Shigella (1780; 3.8) Shiga toxin-producing E coli (STEC) non-O157 (451; 1.0) STEC O157 (442; 0.9) Vibrio (193; 0.4) Yersinia (159; 0.3) Listeria (125; 0.3) In the United States, Yersinia enterocolitica accounts (...) cellulitis and ulcerative conjunctivitis caused by Yersinia enterocolitica O:8. Ophthal Plast Reconstr Surg . 2008 Sep-Oct. 24(5):425-6. . Tennant SM, Hartland EL, Phumoonna T, Lyras D, Rood JI, Robins-Browne RM, et al. Influence of gastric acid on susceptibility to infection with ingested bacterial pathogens. Infect Immun . 2008 Feb. 76(2):639-45. . . Lamps LW, Madhusudhan KT, Greenson JK, Pierce RH, Massoll NA, Chiles MC, et al. The role of Yersinia enterocolitica and Yersinia pseudotuberculosis

2014 eMedicine Pediatrics

37. Infections in the Immunocompromised Host (Treatment)

species. Asplenia (congenital or acquired) predisposes patients to malaria, babesiosis, and infection by encapsulated organisms, including the following: S pneumoniae, H influenzae, E coli, K pneumoniae, Neisseria meningitidis, and Capnocytophaga canimorsus . [ ] Iron overload predisposes patients to Yersinia, Vibrio, and Capnocytophaga infections. Leukemia or lymphoma predisposes patients to infections with S aureus, coagulase-negative staphylococci, P aeruginosa, enteric organisms, fungi [ ] , S (...) , Vibrio vulnificans, Aeromonas species Metabolic complications - S aureus infection, candidiasis, mucormycosis Pregnancy complications - S agalactiae, Candida species, Listeria species, hepatitis E virus Pulmonary complications Asthma predisposes patients to invasive pneumococcal infections. Asthma and atopy predispose to viral infections (rhinovirus) [ ] CF predisposes to infections with S aureus, H influenzae, P aeruginosa (mucoid in CF), S marcescens, B cepacia, Stenotrophomonas maltophilia

2014 eMedicine Pediatrics

38. Necrotizing Fasciitis and Purpura Fulminans

. This serotype 5 antigen is included in the polysaccharide 23-valent pneumococcal vaccine, highlighting the value of pneumococcal immunization. In type I necrotizing fasciitis, anaerobic and facultative bacteria work synergistically to cause what may initially be mistaken for a simple wound cellulitis. A variant of type I necrotizing fasciitis is saltwater necrotizing fasciitis in which an apparently minor skin wound is contaminated with saltwater containing a Vibrio species. In type II necrotizing fasciitis (...) referred to as hemolytic streptococcal gangrene, Meleney ulcer, acute dermal gangrene, hospital gangrene, suppurative fasciitis, and synergistic necrotizing cellulitis. is a form of necrotizing fasciitis that is localized to the scrotum and perineal area. Necrotizing fasciitis may occur as a complication of a variety of surgical procedures or medical conditions, including cardiac catheterization, [ ] vein sclerotherapy, [ ] and diagnostic laparoscopy, [ ] among others. [ , , , , , , ] It may also

2014 eMedicine Surgery

39. Infections in the Immunocompromised Host (Follow-up)

species. Asplenia (congenital or acquired) predisposes patients to malaria, babesiosis, and infection by encapsulated organisms, including the following: S pneumoniae, H influenzae, E coli, K pneumoniae, Neisseria meningitidis, and Capnocytophaga canimorsus . [ ] Iron overload predisposes patients to Yersinia, Vibrio, and Capnocytophaga infections. Leukemia or lymphoma predisposes patients to infections with S aureus, coagulase-negative staphylococci, P aeruginosa, enteric organisms, fungi [ ] , S (...) , Vibrio vulnificans, Aeromonas species Metabolic complications - S aureus infection, candidiasis, mucormycosis Pregnancy complications - S agalactiae, Candida species, Listeria species, hepatitis E virus Pulmonary complications Asthma predisposes patients to invasive pneumococcal infections. Asthma and atopy predispose to viral infections (rhinovirus) [ ] CF predisposes to infections with S aureus, H influenzae, P aeruginosa (mucoid in CF), S marcescens, B cepacia, Stenotrophomonas maltophilia

2014 eMedicine Pediatrics

40. Yersinia Enterocolitica Infection (Diagnosis)

, preliminarily identified a total of 19,089 laboratory-confirmed cases of infection caused by bacterial pathogens that are commonly transmitted through food. The number of cases and incidence per 100,000 population were reported as follows [ ] : Salmonella (8256; 17.6) Campylobacter (6365; 13.6) Shigella (1780; 3.8) Shiga toxin-producing E coli (STEC) non-O157 (451; 1.0) STEC O157 (442; 0.9) Vibrio (193; 0.4) Yersinia (159; 0.3) Listeria (125; 0.3) In the United States, Yersinia enterocolitica accounts (...) cellulitis and ulcerative conjunctivitis caused by Yersinia enterocolitica O:8. Ophthal Plast Reconstr Surg . 2008 Sep-Oct. 24(5):425-6. . Tennant SM, Hartland EL, Phumoonna T, Lyras D, Rood JI, Robins-Browne RM, et al. Influence of gastric acid on susceptibility to infection with ingested bacterial pathogens. Infect Immun . 2008 Feb. 76(2):639-45. . . Lamps LW, Madhusudhan KT, Greenson JK, Pierce RH, Massoll NA, Chiles MC, et al. The role of Yersinia enterocolitica and Yersinia pseudotuberculosis

2014 eMedicine Pediatrics

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