A case of Vibrio vulnificus Infection Showing Characteristic Hemodynamics and Rapid Worsening in Clinical Course

• Inoue Fumitaka

  Division of Cardiology, Nara Prefectural Hospital

• Thoma Yoshiki

  Osaka Prefectural Nakakawachi Medical Center of Acute Medicine

• Shiono Shigeru

  Osaka Prefectural Nakakawachi Medical Center of Acute Medicine

• Tabuse Hisayuki

  Osaka Prefectural Nakakawachi Medical Center of Acute Medicine

• Saito Yoshihiko

  First Department of Internal Medicine, Nara Medical University

Bibliographic Information

Other Title

• 特徴的な血行動態を呈し急激に悪化したＶｉｂｒｉｏ　ｖｕｌｎｉｆｉｃｕｓ感染症の１例

Abstract

A previously healthy 60-yaer-old man was transported to our hospital suffering from pain in the left arm and right leg. His arm and leg exhibited purpura. His blood pressure was 138/100 mmHg and body temperature was 35.5°C. Laboratory test showed CRP and CK levels of 16.5 mg/dl and 4,268 U/l, respectively. Right leg angiogram indicated severe arterial spasm of the popliteal artery. Hemodynamics evaluation with a Swan-Ganz catheter demonstrated a low cardiac output and high peripheral vascular resistance. Prostaglandin E1 and antibiotics were administrated and continuous hemodiafiltration was performed, but these approaches were not effective. The purpura and rhabdomyolysis became progressively worse, and the patient died after 18 hrs after admission. Vibrio vulnificus was detected from blood culture. This case was diagnosed as infection with V. vulnificus. The angiogram and hemodynamics suggest that insufficiency of peripheral arterial circulation due to severe vasospasm has a significant connection with the rapid worsening in clinical course.

Journal

• Nihon Kyukyu Igakukai Zasshi

  Nihon Kyukyu Igakukai Zasshi 18 (2), 58-64, 2007

  Japanese Association for Acute Medicine

Keywords

• <i>Vibrio vulnificus</i>
• rhabdomyolysis
• angiography
• vasospasm
• Swan-Ganz catheter

Details

• CRID: 1390001204371240704
• NII Article ID: 130004542142
• NII Article ID: 10018881472
• NII Book ID: AN10284604
• DOI: 10.3893/jjaam.18.58
• ISSN: 18833772
• ISSN: 0915924X
• Web Site: https://search.jamas.or.jp/link/ui/2007166507
• Text Lang: ja
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
• Abstract License Flag: Disallowed