Soft-tissue infections caused by halophilic marine vibrios

R. J. Howard and S. Lieb
Department of Surgery, University of Florida, College of Medicine, Gainesville 32610.

Marine Vibrio bacteria can cause illness and occasionally death to people who are exposed to seawater. These gram-negative bacteria can be found in ocean water and estuaries and in uncooked marine animals; they can cause primary sepsis, gastroenteritis, and soft-tissue infections. During a five-year period from 1981 to 1986, we encountered 51 patients with primary soft-tissue infections caused by marine vibrios. Thirty-nine patients developed cellulitis after direct exposure to ocean water, nine had eaten raw oysters, and three had no obvious exposure to seawater. Twenty-two patients (44%) had an underlying illness that might have made them compromised hosts and predisposed them to infection. Twelve patients developed necrotizing infections. Thirteen patients ultimately died. These infections are susceptible to many antibiotics. Debridement is necessary when tissue necrosis occurs. Surgeons should suspect a marine vibrio infection if cellulitis occurs in a patient who has been near ocean water or has eaten raw oysters. These infections may not become apparent until a traveler has returned home, a place that may be far from the ocean.