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Vibrio vulnificus and iron overload — DTM&H MCQ

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HardTropical Bacterial InfectionsVibrio vulnificus and iron overloadDTM&H

A 28-year-old man in Fiji develops a rapidly progressive skin infection following a coral cut while diving. The wound shows necrotic tissue with a foul smell. Culture grows Vibrio vulnificus. He has a history of chronic hepatitis B with cirrhosis. What makes him particularly susceptible to severe V. vulnificus infection?

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Correct answer: D — Iron overload states associated with chronic liver disease

V. vulnificus is a halophilic Vibrio that causes severe wound infections and septicaemia, particularly in patients with iron overload. Chronic liver disease (cirrhosis, haemochromatosis, hepatitis) is the strongest risk factor because elevated serum iron promotes Vibrio growth — the organism has a siderophore-dependent iron acquisition system. CFR for V. vulnificus septicaemia in liver disease is approximately 50%. Treatment: doxycycline plus a third-generation cephalosporin. Prevention: avoiding raw shellfish and covering wounds when in seawater.

Reference: Manson's Tropical Diseases; CDC