Early clinical manifestations of vibrio necrotising fasciitis.
- Author:
Thean Howe Bryan KOH
1
;
Jiong Hao Jonathan TAN
1
;
Choon-Chiet HONG
1
;
Wilson WANG
1
;
Aziz NATHER
1
Author Information
- Publication Type:Case Reports
- Keywords: LRINEC score; outcome; treatment; vibrio necrotising fasciitis
- MeSH: Aged; Aged, 80 and over; Debridement; End Stage Liver Disease; complications; Fasciitis, Necrotizing; diagnosis; microbiology; surgery; Female; Fever; complications; Hepatitis B; complications; Humans; Hypotension; complications; Male; Middle Aged; Retrospective Studies; Risk Factors; Seafood; Seawater; Severity of Illness Index; Singapore; Skin Transplantation; Vibrio; Vibrio Infections; diagnosis; surgery
- From:Singapore medical journal 2018;59(4):224-227
- CountrySingapore
- Language:English
- Abstract: We present five patients with vibrio necrotising fasciitis, a lethal and disabling disease. Two of these patients had a history of exposure to either warm seawater or raw/live seafood, three had underlying chronic liver disease, and four presented with hypotension and fever. There were three deaths and four patients required intensive care unit stays. Among the two survivors, one had high morbidity. Only one patient met the criteria of Laboratory Risk Indicator for Necrotising Fasciitis score > 6. A clinician should suspect possible vibrio necrotising fasciitis if the following are present: contact with fresh seafood/warm seawater, a known history of chronic liver disease and pain that is out of proportion to cutaneous signs. All patients must be managed via intensive care in high dependency units. We recommend a two-step surgical protocol for patient management involving an initial local debridement, followed by a second-stage radical debridement and skin grafting.
