Which clinical history findings are characteristic of Vibrio infections?

Updated: Jun 21, 2021
  • Author: Hoi Ho, MD; Chief Editor: Michael Stuart Bronze, MD  more...
  • Print
Answer

parahaemolyticus is the leading cause of seafood-associated gastroenteritis in the United States. Most individuals with noncholera Vibrio infections report recent consumption or handling of contaminated seafood such as oysters, clams, crabs, or other shellfish. Others have a history of contact with brackish or salty waters. Persons with immunodeficiency disorders, chronic liver disease, and iron storage disorders may be particularly susceptible to severe infections and have rapid clinical deterioration. With the exception of dramatic clinical progression in wound infection and septicemia, no characteristic signs and symptoms of early-stage noncholera Vibrio infections exist.

Table 3. Clinical Signs and Symptoms of Vibrio Infections (Open Table in a new window)

Clinical Presentation

Symptoms (Frequency)

Gastroenteritis

Diarrhea (100%)

Abdominal cramps (89%)

Nausea (76%)

Vomiting (55%)

Fever (47%)

Bloody stools (29%)

Headache (24%)

Myalgia (24%)

Wound infection

Swelling (100%)

Pain (100%)

Erythema (100%)

Bullae (30-50%)

Necrosis (30-50%)

Gangrene (< 10%)

Septicemia

Fever (>90%)

Hypothermia (< 10%)

Hypotension (100%)

Tachycardia (80-90%)

Shock (50-70%)

Bullae (80-100%)

Acute respiratory distress syndrome (< 5%)

Multiple organ dysfunction (30-50%)

Although atypical infections with Vibrio species involving peritonitis, pneumonia, endometritis, meningitis, septic arthritis, osteomyelitis, and keratitis have been reported, in general, Vibrio causes 3 clinical symptoms: gastroenteritis, skin and soft tissue infections, and septicemia.

Gastroenteritis

After an average incubation period of 19 hours (range, 12-52 h), patients with Vibrio gastroenteritis report abdominal pain or cramps, nausea, vomiting diarrhea, fevers and chills. [40] Patients frequently pass several watery stools (10-15/d). The occurrence of bloody diarrhea varies. It is reported in 25% of patients with V parahaemolyticus infection but may develop in up to 75% of patients with V fluvialis infection.

Low-grade fever may be observed in patients with Vibrio gastroenteritis.

Most patients remain alert upon admission. However, elderly patients may have decreased mental status due to dehydration or sepsis. Death is rare, but would most likely be caused by concomitant Vibrio septicemia.

Skin and soft tissue infections

Patients frequently report injury associated with handling contaminated shellfish (preparation of St Peter's fish (Tilapia zillii) and preparation of crabs, lobsters, or mussels), particularly fishhooks within the fish. Injuries can also be sustained when stepping on seashells, crustaceans, or stingrays. [41]

Initially, patients with such infections almost always report severe pain of the involved limb or body part. Numbness of the wound and the surrounding area may predominate if the patient has delayed seeking medical attention.

Septicemia

Symptoms usually occur within 7-14 days of contact. Patients frequently exhibit a dramatic clinical presentation of bacteremia, minus a clear focus. This may be characterized by the abrupt onset of the following:

  • High fever

  • Shaking chills

  • Generalized myalgia

  • Exquisite pain in the lower extremities (most characteristic) or, rarely, pain in the lower trunk [42]


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!