Necrotizing fasciitis and sepsis caused by Vibrio vulnificus and Klebsiella pneumoniae in diabetic patients
Background: Vibrio vulnificus related necrotizing fasciitis is a fatal, rapidly progressive soft-tissue infection. Necrotizing fasciitis caused by Klebsiella pneumoniae is rare, which is indistinguishable from V. vulnificus infection in the emergency room. The purpose of this study was to compare th...
Main Authors: | , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Elsevier
2015-04-01
|
Series: | Biomedical Journal |
Subjects: | |
Online Access: | http://www.biomedj.org/article.asp?issn=2319-4170;year=2015;volume=38;issue=2;spage=136;epage=142;aulast=Hsu |
id |
doaj-c3c9cfbc9ca34cd0a368f28af359cc3e |
---|---|
record_format |
Article |
spelling |
doaj-c3c9cfbc9ca34cd0a368f28af359cc3e2021-03-02T09:22:41ZengElsevierBiomedical Journal2319-41702320-28902015-04-0138213614210.4103/2319-4170.137767Necrotizing fasciitis and sepsis caused by Vibrio vulnificus and Klebsiella pneumoniae in diabetic patientsJiun-Cheng Hsu Shih-Hsun Shen Tien-Yu Yang Po-Han Chen Kuo-Chin HuangYao-Hung TsaiBackground: Vibrio vulnificus related necrotizing fasciitis is a fatal, rapidly progressive soft-tissue infection. Necrotizing fasciitis caused by Klebsiella pneumoniae is rare, which is indistinguishable from V. vulnificus infection in the emergency room. The purpose of this study was to compare the clinical characteristics and outcome between these two pathogens in diabetic patients. Methods: Thirty diabetic patients were retrospectively reviewed over an 8-year period. Necrotizing fasciitis caused by V. vulnificus was found in 19 patients and by K. pneumoniae in 11 patients. The demographic, clinical, and laboratory characteristics, and the outcome between diabetic patients with V. vulnificus and K. pneumoniae infections were compared. Results: Two patients in the V. vulnificus group (10.5%) and three patients in the K. pneumoniae group (27.3%) died. Fourteen patients in the V. vulnificus group (73.6%) had a history of exposure to seawater or raw seafood, and eight patients in the K. pneumoniae group (72.8%) had abrasions or chronic ulcers over the site of infection. We found that the time interval between onset of illness and presentation to the hospital was significantly shorter in the V. vulnificus group than in the K. pneumoniae group (2.47 days vs. 5.45 days, p < 0.001). Conclusions: The exposure history and the time from exposure to hospital presentation with severe sepsis syndromes should alert clinicians to distinguish between necrotizing soft-tissue infections with V. vulnificus (contact with seawater or raw seafood) and K. pneumoniae (abrasions or chronic ulcers) in diabetic patients. Infection with V. vulnificus progresses more rapidly than infection with K. pneumoniae during the initial clinical course.http://www.biomedj.org/article.asp?issn=2319-4170;year=2015;volume=38;issue=2;spage=136;epage=142;aulast=Hsuklebsiella pneumonianecrotizing fasciitisVibrio vulnificus |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jiun-Cheng Hsu Shih-Hsun Shen Tien-Yu Yang Po-Han Chen Kuo-Chin Huang Yao-Hung Tsai |
spellingShingle |
Jiun-Cheng Hsu Shih-Hsun Shen Tien-Yu Yang Po-Han Chen Kuo-Chin Huang Yao-Hung Tsai Necrotizing fasciitis and sepsis caused by Vibrio vulnificus and Klebsiella pneumoniae in diabetic patients Biomedical Journal klebsiella pneumonia necrotizing fasciitis Vibrio vulnificus |
author_facet |
Jiun-Cheng Hsu Shih-Hsun Shen Tien-Yu Yang Po-Han Chen Kuo-Chin Huang Yao-Hung Tsai |
author_sort |
Jiun-Cheng Hsu |
title |
Necrotizing fasciitis and sepsis caused by Vibrio vulnificus and Klebsiella pneumoniae in diabetic patients |
title_short |
Necrotizing fasciitis and sepsis caused by Vibrio vulnificus and Klebsiella pneumoniae in diabetic patients |
title_full |
Necrotizing fasciitis and sepsis caused by Vibrio vulnificus and Klebsiella pneumoniae in diabetic patients |
title_fullStr |
Necrotizing fasciitis and sepsis caused by Vibrio vulnificus and Klebsiella pneumoniae in diabetic patients |
title_full_unstemmed |
Necrotizing fasciitis and sepsis caused by Vibrio vulnificus and Klebsiella pneumoniae in diabetic patients |
title_sort |
necrotizing fasciitis and sepsis caused by vibrio vulnificus and klebsiella pneumoniae in diabetic patients |
publisher |
Elsevier |
series |
Biomedical Journal |
issn |
2319-4170 2320-2890 |
publishDate |
2015-04-01 |
description |
Background: Vibrio vulnificus related necrotizing fasciitis is a fatal, rapidly progressive soft-tissue infection. Necrotizing fasciitis caused by Klebsiella pneumoniae is rare, which is indistinguishable from V. vulnificus infection in the emergency room. The purpose of this study was to compare the clinical characteristics and outcome between these two pathogens in diabetic patients.
Methods: Thirty diabetic patients were retrospectively reviewed over an 8-year period. Necrotizing fasciitis caused by V. vulnificus was found in 19 patients and by K. pneumoniae in 11 patients. The demographic, clinical, and laboratory characteristics, and the outcome between diabetic patients with V. vulnificus and K. pneumoniae infections were compared.
Results: Two patients in the V. vulnificus group (10.5%) and three patients in the K. pneumoniae group (27.3%) died. Fourteen patients in the V. vulnificus group (73.6%) had a history of exposure to seawater or raw seafood, and eight patients in the K. pneumoniae group (72.8%) had abrasions or chronic ulcers over the site of infection. We found that the time interval between onset of illness and presentation to the hospital was significantly shorter in the V. vulnificus group than in the K. pneumoniae group (2.47 days vs. 5.45 days, p < 0.001).
Conclusions: The exposure history and the time from exposure to hospital presentation with severe sepsis syndromes should alert clinicians to distinguish between necrotizing soft-tissue infections with V. vulnificus (contact with seawater or raw seafood) and K. pneumoniae (abrasions or chronic ulcers) in diabetic patients. Infection with V. vulnificus progresses more rapidly than infection with K. pneumoniae during the initial clinical course. |
topic |
klebsiella pneumonia necrotizing fasciitis Vibrio vulnificus |
url |
http://www.biomedj.org/article.asp?issn=2319-4170;year=2015;volume=38;issue=2;spage=136;epage=142;aulast=Hsu |
work_keys_str_mv |
AT jiunchenghsu necrotizingfasciitisandsepsiscausedbyvibriovulnificusandklebsiellapneumoniaeindiabeticpatients AT shihhsunshen necrotizingfasciitisandsepsiscausedbyvibriovulnificusandklebsiellapneumoniaeindiabeticpatients AT tienyuyang necrotizingfasciitisandsepsiscausedbyvibriovulnificusandklebsiellapneumoniaeindiabeticpatients AT pohanchen necrotizingfasciitisandsepsiscausedbyvibriovulnificusandklebsiellapneumoniaeindiabeticpatients AT kuochinhuang necrotizingfasciitisandsepsiscausedbyvibriovulnificusandklebsiellapneumoniaeindiabeticpatients AT yaohungtsai necrotizingfasciitisandsepsiscausedbyvibriovulnificusandklebsiellapneumoniaeindiabeticpatients |
_version_ |
1724239555200024576 |