Vibrio vulnificus

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  • History of handling or ingestion of raw seafood (most commonly oysters)
    • Handling: rapid cellulitis that progresses to hemorrhagic bullae and purpura fulminans
    • Ingestion: vomiting, diarrhea, or abdominal pain, and may present with fever, chills, or shock
    • Patients with cirrhosis at high risk
  • Severe Complications[1]
    • Necrotizing fasciitis and septicemia
    • Immediate and intensive empirical antibiotic treatment
    • Surgical debridement in suspected cases

Vibrio species


Clinical Features

Differential Diagnosis



Antibiotic Sensitivities[2]

Category Antibiotic Sensitivity
Penicillins Penicillin G X1
Penicillin V X1
Anti-Staphylocccal Penicillins Methicillin X1
Nafcillin/Oxacillin X1
Cloxacillin/Diclox. X1
Amino-Penicillins AMP/Amox X1
Amox-Clav X1
AMP-Sulb X1
Anti-Pseudomonal Penicillins Ticarcillin X1
Ticar-Clav X1
Pip-Tazo X1
Piperacillin X1
Carbapenems Doripenem X1
Ertapenem X1
Imipenem X1
Meropenem X1
Aztreonam X1
Fluroquinolones Ciprofloxacin X1
Ofloxacin X1
Pefloxacin X1
Levofloxacin X1
Moxifloxacin X1
Gemifloxacin X1
Gatifloxacin X1
1st G Cephalo Cefazolin X1
2nd G. Cephalo Cefotetan X1
Cefoxitin X1
Cefuroxime X1
3rd/4th G. Cephalo Cefotaxime X1
Cefizoxime X1
CefTRIAXone X1
Ceftaroline X1
CefTAZidime X1
Cefepime X1
Oral 1st G. Cephalo Cefadroxil X1
Cephalexin X1
Oral 2nd G. Cephalo Cefaclor/Loracarbef X1
Cefproxil X1
Cefuroxime axetil X1
Oral 3rd G. Cephalo Cefixime X1
Ceftibuten X1
Cefpodox/Cefdinir/Cefditoren X1
Aminoglycosides Gentamicin I
Tobramycin I
Amikacin I
Chloramphenicol X2
Clindamycin X1
Macrolides Erythromycin X1
Azithromycin X1
Clarithromycin X1
Ketolide Telithromycin X1
Tetracyclines Doxycycline S+
Minocycline S+
Glycylcycline Tigecycline X1
Daptomycin R
Glyco/Lipoclycopeptides Vancomycin X1
Teicoplanin X1
Telavancin X1
Fusidic Acid R
Trimethoprim X1
Urinary Agents Nitrofurantoin X1
Fosfomycin X1
Other Rifampin X1
Metronidazole R
Quinupristin dalfoppristin X1
Linezolid X1
Colistimethate X1


  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

Table Overview

See Also


  1. Choi HJ, Lee DK, Lee MW, Choi JH, Moon KC, Koh JK. Vibrio vulnificus septicemia presenting as purpura fulminans. J Dermatol. Jan 2005;32(1):48-51.
  2. Sanford Guide to Antimicrobial Therapy 2014


See Also

External Links