Vibrio vulnificus infection can present as a gastrointestinal illness (vomiting, diarrhea, abdominal pain) or a more severe bloodstream infection (fever, chills, skin lesions, shock), with diagnosis relying on culture and history of seafood consumption or seawater exposure.
Symptoms and Presentations:
Gastrointestinal Illness:
V. vulnificus can cause a sudden onset of fever, chills, watery diarrhea, nausea, and vomiting.
Septicemia (Bloodstream Infection):
This can lead to a life-threatening condition with symptoms like fever, chills, decreased blood pressure (septic shock), and blistering skin lesions (hemorrhagic bullae, ecchymosis).
Wound Infections:
Exposure of open wounds to seawater can lead to skin redness, warmth, swelling, and pain (cellulitis).
Necrotizing Fasciitis:
In rare cases, V. vulnificus can cause necrotizing fasciitis, a serious infection of the deep tissues.
Diagnosis:
History:
A history of consuming raw or undercooked seafood, especially oysters, or exposure to coastal water, including salt water or brackish water, is important.
Laboratory Tests:
Blood Cultures: Recommended if the patient is febrile, has hemorrhagic bullae, or has signs of sepsis.
Stool Cultures: To rule out gastrointestinal infection.
Wound Cultures: To identify the presence of V. vulnificus in wound infections.
Polymerase Chain Reaction (PCR): Can be used for rapid detection of V. vulnificus.
Considerations:
V. vulnificus infection should be considered in immunocompromised patients who have recently been exposed to seawater or consumed raw seafood.
A high index of suspicion is required to diagnose V. vulnificus infection with rare presentations.
Risk Factors:
Underlying Medical Conditions:
Individuals with chronic liver disease (cirrhosis, alcoholic liver disease, chronic hepatitis B or C), diabetes, end-stage renal disease, rheumatoid arthritis, and hemochromatosis are at higher risk for serious V. vulnificus infections.
Alcohol Abuse:
Alcohol abuse, even without documented liver disease, can increase the risk.

Vibrio vulnificus infections, particularly wound infections and primary septicemia, can cause severe skin manifestations like cellulitis, ecchymoses (bruising), and hemorrhagic bullae (large, blood-filled blisters).
Here’s a more detailed breakdown of the skin manifestations:
Cellulitis:
A rapid onset of painful, swollen, and red skin, potentially progressing to necrotizing fasciitis (tissue death).
Ecchymoses and Hemorrhagic Bullae:
Large, blood-filled blisters, often appearing within 24 hours of symptom onset, are characteristic of primary septicemia.
Necrotizing Fasciitis:
A serious infection of the soft tissues and fascia, potentially requiring surgical debridement or even amputation.
Skin Lesions:
In wound infections, skin lesions may appear at the site of the wound, potentially progressing to ulcers or necrotic tissue.
Wound Infection:
Can occur when open wounds are exposed to seawater or contaminated seafood, leading to severe skin infections.
Primary Septicemia:
A bloodstream infection, often caused by consuming contaminated seafood, can lead to fever, chills, septic shock, and severe skin lesions.
Systemic Symptoms:
In addition to skin manifestations, V. vulnificus infections can cause fever, chills, nausea, vomiting, diarrhea, and changes in mental status.
Important Considerations:
High-Risk Individuals:
People with weakened immune systems (e.g., due to liver disease, kidney disease, or diabetes) are at higher risk for severe V. vulnificus infections.
Prompt Medical Attention:
If you suspect a V. vulnificus infection, seek immediate medical care, as the infection can be life-threatening.
Prevention:
Avoid consuming raw or undercooked seafood, and be cautious when handling seafood or exposing open wounds to seawater, particularly in warm coastal areas.