case_images: PMC6514507_01
case_images: aVibrio parahaemolyticus-infected left leg ulcer at the time of admission to our department. bV. parahaemolyticus-infected left leg ulcer at the time of cellulitis and septic shock. c Left leg ulcer after negative-pressure wound therapy. d Left leg ulcer after split-thickness skin grafting.
case_images: cde-0011-0094-g01.jpg
case_images: PMC6514507_01_cde-0011-0094-g01.jpg
case_images: F1
case_images: On clinical examination, we observed an ulcer extending to his left lateral ankle (70 x 50 mm) with a fibrinous, greenish and smelly coating (Fig. 1a). Within 12 h, he had developed cellulitis in the left leg (Fig. 1b), then hypotension, acute renal failure and a septic shock, for which the antibiotic was changed to parenteral imipenem 500 mg twice daily, and he was treated with intravenous catecholamines at the intensive care unit for 3 days. Four months later, we obtained a satisfactory granulation of the wound ground (Fig. 1c). We proceeded with application of a split-thickness skin graft to the left leg, which resulted in complete wound healing (Fig. 1d).
case_images: a Left: Vibrio parahaemolyticus growth on TCBS (Thiosulfate-Citrate-Bile-Sucrose) Agar; right: V. parahaemolyticus growth on sheep blood agar showing haemolysis. b Native preparation, under the microscope showing the presence of V. parahaemolyticus. Note that this Vibrio strain is not the same as in our patient, but provided by the Institute of Medical Microbiology in Zurich.
case_images: cde-0011-0094-g02.jpg
case_images: PMC6514507_01_cde-0011-0094-g02.jpg
case_images: F2
case_images: Blood cultures showed growth of V. parahaemolyticus in 4/4 bottles (Fig. 2).