FatalVibrio vulnificusInfection Associated with Eating Raw Oysters, New Caledonia

Fatal Vibrio vulnifi cus Infection Associated with Eating Raw Oysters, New CaledoniaTo the Editor: The bacterium Vibrio vulnifi cus is a marine fl ora saprophyte that can cause necrotic skin infection and septicemia in humans who eat shellfi sh.Symptoms of septicemia (mortality rate >50%) have been described mostly in Florida and Japan among persons who ate raw fi lter-feeding shellfi sh when seawater temperatures are >20°C (1).V. vulnifi cus-related septicemia introduced through the digestive system appears within 7 days after ingestion (2).Clinical signs and symptoms include fever, collapse, and metastatic necrotic skin lesions.We report 3 patients from New Caledonia who died after V. vulnifi cus infection, which they probably acquired by eating contaminated oysters.These patients were hospitalized during February-May 2008 at Noumea Hospital (Noumea, New Caledonia).Patient 1 was a 51-year-old man with fever, muscle pains, bleeding gums, and a history of alcohol abuse; within 48 hours after symptom onset, he died of septic shock, with diffuse ecchymoses and purpura.Patient 2 was a 67-year-old woman with no known concurrent conditions who was admitted to the hospital with chills, diarrhea, and vomiting; septic shock developed, with painful erythematous plaques on the lower limbs becoming foamy, confl uent, and necrotic.Patient 3 was a 74-year-old woman with untreated lupus who was hospitalized with lower-limb edema, hypotension, hypothermia, and erythematous skin lesions.All 3 patients received cephalosporins but died of multiple organ failure within 12 hours after hospital admission.