A Case of Vibrio vulnificus Sepsis: A Potential Use of Extracorporeal Membrane Oxygenation.
- Author:
Sun Young PARK
1
;
Hyunseung NAM
;
Sunghoon PARK
;
Jae Yong PARK
;
Sang Ook HA
;
Sun Hee LEE
;
Hyoung Soo KIM
Author Information
1. Department of Internal Medicine,Hallym University Sacred Heart Hospital, Anyang, Korea.
- Publication Type:Case Report
- Keywords:
Extracorporeal membrane oxygenation;
Fasciitis;
necrotizing;
Sepsis;
Vibrio vulnificus
- MeSH:
Amputation;
C-Reactive Protein;
Debridement;
Drainage;
Extracorporeal Membrane Oxygenation*;
Fasciitis;
Fasciitis, Necrotizing;
Humans;
Hypotension;
Intensive Care Units;
Lactic Acid;
Leg;
Sepsis*;
Shock, Septic;
Vibrio vulnificus*;
Vibrio*;
Vital Signs;
Wound Healing
- From:Journal of the Korean Society of Emergency Medicine
2017;28(1):133-137
- CountryRepublic of Korea
- Language:English
-
Abstract:
Necrotizing fasciitis caused by Vibrio vulnificus can rapidly progress to septic shock and death. Hence, early surgical debridement of the involved tissue is vital. However, this can be a challenging task due to the coagulopathy and unstable conditions often associated with these patients. Herein, we present a patient with necrotizing fasciitis caused by V. vulnificus who received extracorporeal membrane oxygenation (ECMO) support for refractory hypotension. After initiating ECMO, his vital signs stabilized, and lactate, C-reactive protein, and procalcitonin levels continued to decrease. He underwent several rounds of surgical debridement and vacuum-assisted drainage on both lower legs. On ECMO day 15, he was successfully weaned off the device and his condition was uneventful for several days. However, on the 24th day of intensive care unit (ICU), he was again placed on ECMO due to clinical deterioration. On ICU day 32, he underwent bilateral below-knee amputations due to delayed wound healing. Unfortunately, he subsequently developed multi-organ failure and died. Nonetheless, this case is instructive regarding the potential use of ECMO. We suggest that ECMO could provide the necessary time for sepsis patients to undergo aggressive medical and surgical interventions.
