Vibrio fluvialis – Unusual Case of Cellulitis Leading to Sepsis

Vibrio fluvialis, an enteric, Gram negative bacterium commonly isolated from sewage/ sea water contaminated with human and animal’s faeces. Infections with this unusual organism can cause cholera like bloody diarrhoea and also wound infection. Vibrio fluvialis causing skin infection and sepsis is uncommon with very few cases reported worldwide. It is an emerging pathogen with distinct features as compares to the other species of Vibrio group of bacteria in terms of high virulence and adaptability in hostile environments. Here is a case report of skin and soft tissue infection by Vibrio fluvialis, in a patient suffering from severe pedal oedema due to nephrotic syndrome and right lower limb deep vein thrombosis .

Case Report: A young male, farmer, presented with ascites, pedal oedema, puffy face due to nephrotic syndrome.He developed skin and soft tissue infection resulted from skin atrophy and ulcer due to pedal oedema as well as right limb deep vein thrombosis . He had high grade fever, leucocytosis, anaemia, hypoproteinaemia, right leg cellulites and features of sepsis requiring wound debridement. Immunodeficiency and corticosteroids associated immunosuppression were absent in this patient. He was diagnosed with nephrotic syndrome due to minimal change disease.

Conclusion: Vibrio fluvialis infection can occur due to wound contaminated with sewage water leading to skin and soft tissue infection and life threatening sepsis.