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Inland presentation of Vibrio vulnificus primary septicemia and necrotizing fasciitis.

Vibrio vulnificus, a halophilic Vibrio species recently described by Hollis and co-workers,1 is part of the normal marine flora of Atlantic coastal and Gulf of Mexico waters.2 3 This organism can be extremely virulent in humans and, as described by Blake and associates,4 causes primarily two clinical syndromes in infected persons. Wound infections result from contact of wounds with saltwater harboring V vulnificus or from puncture wounds acquired by handling shellfish harvested from such environments. Primary septicemia is caused by ingesting raw shellfish (generally oysters) containing this Vibrio species and is characterized by the rapid development of sepsis, secondary metastatic skin lesions and a mortality rate as high as 67% . Cases of V vulnificus primary septicemia in the United States have been clustered about the Atlantic and the Gulf seaboards, paralleling the ecology described for this Vibrio species.34 No documented cases of primary septicemia have been reported in western states to our knowledge. In this article we report a case of V vulnificus primary septicemia in Salt Lake City, Utah.