Among the noncholera vibrios, it is the most important cause of serious disease. V. vulnificus is extremely invasive and can produce necrotizing vasculitis, gangrene, and shock. An important clue to V. vulnificus infection is the development of bullous skin lesions. About three fourths of patients infected with V. vulnificus who have primary septicemia have underlying hepatic disease. Other chronic conditions that predispose to septicemia in patients infected with V. vulnificus include hemochromatosis, chronic renal failure, immunosuppressive therapy, diabetes, and congestive heart failure.
Therapy consists of adequate debridement and parenteral antibiotics.
Tetracycline is probably the antibiotic of choice. Vibrio parahaemolyticus V. parahaemolyticus is a halophilic organism that can be isolated from seawater, zooplankton, fish, and shellfish. Not surprisingly, V. parahaemolyticus is a major cause of gastroenteritis in Japan and a not uncommon cause of food poisoning in the United States, particularly in the Chesapeake Bay area, along the Gulf Coast, and in the Pacific Northwest. Strains of V. parahaemolyticus from the Pacific Northwest appear to be able to produce gastroenteritis even though they are Kanagawa test negative. The diarrhea is usually self-limited and lasts for less than one week.