Vibrio fluvialis Bacteremia With Bullous Cellulitis

TL;DR

A rare case of Vibrio fluvialis infection causing severe skin and blood infection is reported without typical risk factors.

Contribution

This case highlights Vibrio fluvialis as an emerging extraintestinal pathogen with atypical clinical presentation.

Findings

Vibrio fluvialis bacteremia was associated with bullous cellulitis in a patient without gastrointestinal symptoms.

The patient required above-the-knee amputation due to complications from the infection.

Co-infection with Streptococcus dysgalactiae was identified in blood cultures.

Abstract

Vibrio fluvialis is a gram-negative bacillus commonly implicated in outbreaks of gastroenteritis. The bacterium has been identified as an emerging pathogen in recent years, with increasing reports of extraintestinal manifestations. This report discusses a case of bacteremia presumed secondary to bullous cellulitis of the left lower extremity, with blood cultures positive for Vibrio fluvialis and Streptococcus dysgalactiae. The patient presented with progressively worsening quadriplegia and falls, with one week of progressive discoloration of the left lower extremity. He denied any gastrointestinal symptoms and had no recent history of seawater exposure or seafood consumption. Initial inpatient management consisted of parenteral antibiotics, although complications eventually necessitated an above-the-knee amputation (AKA).

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