Unaware infection
The Department of Emergency Medicine and Intensive Care (Hanoi Medical University Hospital) received a 38-year-old male patient, a teacher at a highland primary school in Son La, admitted to the hospital due to fever on the second day and accompanying joint pain on both sides, extreme fatigue. Only had a fever for 2 days, but as soon as he entered the hospital, the patient went into septic shock, multi-organ failure, respiratory failure, heart failure, and kidney failure. At the same time, the patient responded very poorly to initial aggressive treatment measures, and the infection continued to progress throughout the body.
The patient's blood culture results showed the bacterium Burkholderia pseudomallei causes Whitmore's disease.
At Central Military Hospital 108, a male patient (64 years old), in Giao Thuy district, Nam Dinh province, was taken to the Department of Internal Medicine and Poison Control in a state of septic shock and multiple organ failure. The patient has a rapidly spreading lower foot infection.
The patient's initial damage was in the foot area around the open wound. After a few hours, it quickly spread to the lower leg and left thigh with symptoms of sharp pain, blisters, bruising of the damaged skin, and sensory disturbances. The injury was determined to be necrotizing fasciitis causing severe toxic infection.
After admission to the hospital, the patient received mechanical ventilation, dialysis, extensive skin incision, fascia of the lesion, wound culture, and blood culture. The results were positive for Vibrio vulnificus bacteria - a type of gram-negative bacteria, considered one of the "flesh-eating bacteria" because its toxins destroy connective tissue and tissues in the body. This bacterium often causes widespread necrotizing fasciitis and is quickly fatal if not treated promptly.
High mortality rate
According to medical literature, cases of Burkholderia pseudomallei infection with septic shock have an extremely high mortality rate. The bacteria will spread throughout the body, forming many whole-body abscesses that respond very poorly to antibiotics. For that reason, Burkholderia pseudomallei is known as flesh-eating bacteria.
MSc. Nguyen Thi Huyen Trang, Department of Internal Medicine and Poison Control, Intensive Care Center (Military Central Hospital 108) said that in the case of a 64-year-old patient with Vibrio vulnificus bacteria, it is often treated. found in saltwater, brackish tropical and subtropical coastal water environments with water temperatures above 20 degrees Celsius. The risk of Vibrio vulnificus infection can be due to eating foods containing the bacteria such as raw oysters or exposure to the bacteria. bacteria through open wounds such as direct contact with sea water or brackish water during work and play at sea. People susceptible to infection are people with chronic diseases, immunodeficiency, and diabetes.
Common injuries are redness and swelling, pain, blisters or pus inflammation, and skin necrosis that spreads quickly within a few hours or days, accompanied by symptoms of systemic infection, shock, hypotension, organ failure, and coma. coma and death.
Mortality rates are related to the time of early antibiotic use.
According to a report on 62 cases of Vibrio vulnificus infection in Florida, USA, using antibiotics early within 24 hours after hospitalization has a mortality rate of about 33%. This rate increases to 53% when antibiotics are used for 24 - 48 hours and to 100% if antibiotics are used after 48 hours.
This bacteria is sensitive to most antibiotics in vitro (in the laboratory) except Colistin.
To prevent the risk of infection with this "flesh-eating bacteria", people need to avoid eating raw seafood, avoid contact with open wounds with sea water, brackish water or raw seafood, especially shellfish. , be more careful with people with immunodeficiency, diabetes, and chronic diseases. Wash the wound with soap and clean water if exposed to sea water. Go to a medical facility immediately if there are any symptoms of swelling, pain, or blisters in the damaged skin area after exposure to risky environments. .
