What question did this study set out to answer?

The aim is to highlight the severe clinical implications of vibrio vulnificus infection, especially in immunocompromised patients.

February 28, 2026Open Access

Vibrio Vulnificus-Induced Septic Shock Complicated by Necrotizing Fasciitis: A Case Report and Review of Clinical Characteristics

BWBojiang WangQingdao University SLShuzheng LiuQingdao University PZPeixun ZhangQingdao University

Key Points

The aim is to highlight the severe clinical implications of vibrio vulnificus infection, especially in immunocompromised patients.
Case presentation of a 70-year-old female with type 2 diabetes
Use of next-generation sequencing for pathogen confirmation
Monitoring of clinical progression and complications during hospitalization
Patient experienced rapid clinical deterioration with septic shock and necrotizing fasciitis
Surgical intervention was delayed, leading to unfavorable outcomes and discharge against medical advice
Antibiotic therapy alone proved insufficient for managing the infection

Abstract

Background: Vibrio vulnificus is a halophilic marine bacterium capable of causing rapidly progressive septic shock and necrotizing fasciitis, particularly in immunocompromised individuals. Mortality rates remain high due to the fulminant nature of the infection and diagnostic challenges. Case Presentation: A 70-year-old female with poorly controlled type 2 diabetes presented with fever and septic shock 48 hours after ingesting raw seafood. The clinical course was characterized by rapid deterioration, severe coagulopathy, and the development of extensive necrotizing fasciitis in the right upper limb. Vibrio vulnificus infection was confirmed via next-generation sequencing (NGS) on hospital day 6. Despite broad-spectrum antibiotic therapy and fluid resuscitation, surgical intervention was delayed until day 9 following multidisciplinary consultation. Intraoperative findings revealed extensive “dishwater” necrosis. The patient suffered from recurrent sepsis, graft failure, and deep vein thrombosis. Due to the rapid progression and delayed source control, the outcome was unfavorable, leading to discharge against medical advice. Conclusion: This case underscores the high mortality risk associated with Vibrio vulnificus infection in immunocompromised individuals, particularly those with diabetes mellitus. Observations from this patient highlight that antibiotic therapy alone is often insufficient for necrotizing soft tissue infections. It is emphasized that in these high-risk populations, early recognition must trigger immediate, aggressive surgical debridement alongside antimicrobial therapy. Delays in surgical source control, even while awaiting molecular confirmation, can irreversibly compromise patient survival. Keywords: vibrio vulnificus, septic shock, necrotizing fasciitis, surgical debridement, case report

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