Vibrio vulnificus septic shock led to the death of a patient who recently acquired a new tattoo, according to a report published in BMJ Case Reports.

The patient, whose medical history included chronic liver disease, had obtained a leg tattoo and then subsequently went swimming in the Gulf of Mexico, exposing the tattoo to seawater. Clinicians immediately suspected V. vulnificus, a potentially lethal bacterial pathogen that can cause necrotizing fasciitis, myositis, sepsis and death. The patient was started on empiric doxycycline and ceftriaxone (though fluoroquinolones have also been proven effective), however despite these efforts, he developed septic shock and died.

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The infection was ultimately confirmed to be V. vulnificus based on blood and wound cultures. The authors noted that this case highlights the increased risk patients with liver disease may have when infected with this deadly pathogen. “Health providers should remain vigilant for V. vulnificus infections in patients with chronic liver disease and raw oyster ingestion or seawater exposure,” they concluded.

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