Fasciitis necroticans ten gevolge van een infectie met <i>Vibrio vulnificus</i> in een palingkwekerij
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Casuïstiek
25-02-2009
Angelique Dijkstra, Jan van Ingen, Pieter H.W. Lubbert, Olga L.M. Haenen en A.V.M. (Lieke) Möller

Necrotizing fasciitis resulting from infection with at an eel hatchery

A 41-year-old man presented with a painful infection in his right hand. He worked at an eel hatchery, where at that time a Vibrio vulnificus infection was raging among the eels. The infection in his right hand developed into necrotizing fasciitis with sepsis, for which reason he was admitted to the Intensive Care. Culture of material from the hand taken during surgery showed an infection with V. vulnificus. Treatment consisted of several surgical debridements and administration of specific antibiotics. A V. vulnificus infection is a very serious infection and left untreated may rapidly lead to death. A possibly underlying disease may negatively influence its course. Indications of a V. vulnificus infection may be found from detailed history-taking, particularly about work and holidays. If necrotizing fasciitis is suspected the treatment of first choice is to immediately explore surgically and start antibiotic treatment.