Korean J Infect Dis.
1997 Jul;29(4):297-303.
Emergency Debridement with Empirical Antibiotics Treatment for Clinically Diagnosed Vibrio Sepsis
- Affiliations
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- 1Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Seoul, Korea.
- 2Department of Nephrology, Ajou University School of Medicine, Seoul, Korea.
- 3Department of General Surgery, Ajou University School of Medicine, Seoul, Korea.
- 4Department of Plastic Surgery, Ajou University School of Medicine, Seoul, Korea.
Abstract
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BACKGROUND: To evaluate the role of emergency debridement performed in conjunction with an empirical antibiotic therapy in clinically diagnosed, full-blown Vibrio vulnificus sepsis.
METHODS
Immediate surgical debridement was performed on 13 out of 15 patients who were clinically diagnosed as having Vibrio vulnificus sepsis.
RESULTS
Among 15 patients Vibrio vulnificus was isolated in 8 patients. Underlying diseases were liver cirrhosis (2), chronic alcohol ingestion or chronic liver disease (10), diabetes mellitus (3), gastrectomy (1) and in 4 cases no underlying condition was identified. All patients had skin lesions such as erythema, bulla, vesicle and gangrene. All but one initially showed variable degree of hypotension, thrombocytopenia, hepatic dysfunction, renal failure and mental confusion. Their mean APACHE III score was 84. Immediate survival (within 48hrs) in clinically diagnosed Vibrio sepsis was 80% (12/15) and long term survival rate among them was 66.6%. Forty-eight hour survival rate in bacteriologically confirmed cases of Vibrio vulnificus sepsis was 75%, where their long-term survival was 62.5%.
CONCLUSION
In treating full-blown Vibrio vulnificus sepsis, immediate emergency surgical debridement performed in conjunction with the empirical antibiotics gives a possibility to improve both immediate and long term prognosis of the disease.
