Massive rhabdomyolysis: A rare presentation of primary vibrio vulnificus septicemia

The importance of serum creatine phosphokinase level in the early diagnosis, and as a prognostic factor, of Vibrio vulnificus infection

“…According to the literature, there have been 60 reported cases of V. vulnificus infection (49 cases of the primary septicaemia type and 11 of the wound infection type) between January 1981 and June 1999 5,9–16 . Thirty‐one (63%) of 49 patients with the primary septicaemia type died, whereas only one (9%) of 11 patients with the wound infection type died.…”

“…The remaining patient had arm involvement, and survived. When we analysed the anatomical sites of initial skin lesions in the 60 reported cases, 5,9–16 33 of 49 patients with primary septicaemia (67%) were initially affected on the legs, and of these 24 (73%) died. Seven of the 49 patients (14%) had initial skin lesions on the arms and three of them (43%) died.…”

“…Data on CPK levels were available in only nine patients from 60 case reports 5,9–16 . In all cases, CPK levels were elevated, and seven patients (78%) died.…”

“…However, the relationship between prognosis and WCC in patients with V. vulnificus infection seems to be unclear from the analyses in the literature. Of the 60 case reports, 5,9–16 51 gave the WCC: 42 patients had the primary septicaemia type and nine the wound infection type. In the 42 patients with the primary septicaemia type, nine of 12 (75%) with WCC < 4 × 10 9 L −1 and 17 of 30 (57%) with WCC > 4 × 10 9 L −1 died.…”