ANSWERS: 2
  • If V. vulnificus is suspected, treatment should be initiated immediately because antibiotics improve survival. Aggressive attention should be given to the wound site; amputation of the infected limb is sometimes necessary. Clinical trials for the management of V. vulnificus infection have not been conducted. The antibiotic recommendations below come from documents published by infectious disease experts; they are based on case reports and animal models. bulleted list item Culture of wound or hemorrhagic bullae is recommended, and all V. vulnificus isolates should be forwarded to a public health laboratory bulleted list item Blood cultures are recommended if the patient is febrile, has hemorrhagic bullae, or has any signs of sepsis bulleted list item Antibiotic therapy: Doxycycline (100 mg PO/IV twice a day for 7-14 days) and a third-generation cephalosporin (e.g.,ceftazidime 1-2 g IV/IM every eight hours) is generally recommended A single agent regimen with a fluoroquinolone such as levofloxacin, ciprofloxacin or gatifloxacin, has been reported to be at least as effective in an animal model as combination drug regimens with doxycycline and a cephalosporin Children, in whom doxycycline and fluoroquinolones are contraindicated, can be treated with trimethoprim-sulfamethoxazole plus an aminoglycoside bulleted list item Necrotic tissue should be debrided; severe cases may require fasciotomy or limb amputation http://www.cdc.gov/ncidod/dbmd/diseaseinfo/vibriovulnificus_g.htm
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