Vibrio Vulnificus-Induced Septic Shock Complicated by Necrotizing Fasciitis: A Case Report and Review of Clinical Characteristics.

BACKGROUND

Vibrio vulnificus is a halophilic marine bacterium capable of causing rapidly progressive septic shock and necrotizing fasciitis, particularly in immunocompromised individuals. Mortality rates remain high due to the fulminant nature of the infection and diagnostic challenges.

CASE PRESENTATION: A 70-year-old female with poorly controlled type 2 diabetes presented with fever and septic shock 48 hours after ingesting raw seafood. The clinical course was characterized by rapid deterioration, severe coagulopathy, and the development of extensive necrotizing fasciitis in the right upper limb. Vibrio vulnificus infection was confirmed via next-generation sequencing (NGS) on hospital day 6. Despite broad-spectrum antibiotic therapy and fluid resuscitation, surgical intervention was delayed until day 9 following multidisciplinary consultation. Intraoperative findings revealed extensive "dishwater" necrosis. The patient suffered from recurrent sepsis, graft failure, and deep vein thrombosis. Due to the rapid progression and delayed source control, the outcome was unfavorable, leading to discharge against medical advice.

CONCLUSION

This case underscores the high mortality risk associated with Vibrio vulnificus infection in immunocompromised individuals, particularly those with diabetes mellitus. Observations from this patient highlight that antibiotic therapy alone is often insufficient for necrotizing soft tissue infections. It is emphasized that in these high-risk populations, early recognition must trigger immediate, aggressive surgical debridement alongside antimicrobial therapy. Delays in surgical source control, even while awaiting molecular confirmation, can irreversibly compromise patient survival.