A 58-year-old man who is immunosuppressed presented with severe left leg pain 1 day after sustaining a scratch from his dog, which had been swimming in warm coastal water. He quickly developed necrotizing bullae secondary to Vibrio vulnificus bacteremia, progressing to septic shock and multiorgan failure. Management included prompt surgical intervention, targeted antibiotics, and immunosuppressant de-escalation. Despite his grave prognosis, he recovered after 23 days. This case highlights an unconventional V vulnificus transmission route, underscoring the need for rapid diagnosis and treatment in high-risk patients with compatible symptoms, regardless of direct water exposure.
Kim et al. (2026) studied this question.