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Vibrio parahemolyticus
From WikEM
Contents
Background
- Shellfish exposure, especially raw oysters
- Salt water contact with skin lesion
Vibrio species
- Vibrio cholerae
- Vibrio vulnificus
- Vibrio parahemolyticus
Clinical Features
- Gastroenteritis > wound infection >> sepsis
- sepsis is less common, but typically occurs 7 to 48 hours after raw oyster ingestion => fever, chills, nausea/vomiting, abdominal pain => shock, bullae => death in approximately 55% [1]
Differential Diagnosis
Nausea and vomiting
Critical
Emergent
- Acute radiation syndrome
- Acute gastric dilation
- Acetaminophen toxicity
- Adrenal insufficiency
- Appendicitis
- Aspirin toxicity
- Bowel obstruction/ileus
- Carbon monoxide poisoning
- Cholecystitis
- CNS tumor
- Digoxin toxicity
- Electrolyte abnormalities
- Elevated ICP
- Gastric outlet obstruction
- Hyperemesis gravidarum
- Pancreatitis
- Peritonitis
- Ruptured viscus
- Testicular torsion/ovarian torsion
- Theophyline toxicity
Nonemergent
- Biliary colic
- Cannabinoid hyperemesis syndrome
- Chemotherapy
- Disulfiram effect
- Erythromycin
- ETOH
- Gastritis
- Gastroenteritis
- Gastroparesis
- Hepatitis
- Ibuprofen
- Labyrinthitis
- Migraine
- Motion sickness
- Narcotic withdrawal
- Thyroid
- Pregnancy
- Peptic ulcer disease
- Renal colic
- UTI
Evaluation
- Diagnosis is clinical (e.g. shellfish consumption + gastroenteritis, saltwater contact with lesion)
- Check electrolytes for repletion if significant vomiting/diarrhea
Management
- Gastroenteritis
- Hydration (e.g. ORS)
- Antibiotics (Floroquinolone OR doxycycline) only in severe or prolonged cases
- Notify public health authorities if epidemic food-borne illness is suspected
- Sepsis, Wound Infections
- Treat severe disease only
- Floroquinolone OR doxycycline OR third-generation cephalosporin
- Treat for 7 to 14 days
- Necrotizing Fasciitis
- Emergent surgical consultation for debridement
Disposition
See Also
External Links
References
- ↑ Blake PA, Merson MH, Weaver RE, Hollis DG, Heublein PC. Disease caused by a marine Vibrio. Clinical characteristics and epidemiology.[N Engl J Med. 1979 Jan 4;300(1):1-5.
