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March 1974

Fulminating Vibrio parahemolyticus Septicemia: A Syndrome of Erythemia Multiforme, Hemolytic Anemia, and Hypotension

Author Affiliations

Miami, Fla

From the University of Miami School of Medicine and Dade County Medical Examiner's Office (Dr. Davis), Miami, Fla. Dr. Ehrenkranz is now with the Cedars of Lebanon Hospital, Miami.

Arch Intern Med. 1974;133(3):479-481. doi:10.1001/archinte.1974.00320150153021

Fatal Vibrio parahemolyticus septicemia has not been reported hitherto, although acute gastroenteritis caused by the organism is well known.1 The facultative halophilic Vibrio plays a substantial role in the cause of summertime food poisoning outbreaks in Japan and recently has been implicated in outbreaks of acute gastroenteritis in the United States. The Vibrio has been recovered in offshore sea water, uncooked sea fish, and fresh and frozen shellfish in the United States, Japan, and Great Britain.1-5

In addition to gastrointestinal symptoms occurring as a result of contaminated seafood ingestion, tissue invasion by V parahemolyticus has been observed in association with recreational exposure in fresh water or saltwater.6 In these cases, direct transdermal invasion is presumed. Roland described a case in a 40-year-old man two days after he went "clamming" in Narragansett Bay.7 The patient had generalized papular hemorrhagic rash, fever, vomiting, diarrhea, and profound hypotension; V

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