• Tingting Wang and Qifeng Huang.
• Department of Nephrology, The First Affiliated Hospital of Hainan Medical University, Haikou, China.
• Medicine (Baltimore). 2024 Oct 4; 103 (40): e39980e39980.

RationaleVibrio vulnificus is a gram-negative bacterium that can cause 3 clinical syndromes: gastrointestinal symptoms, skin septicemia, and primary septicemia. V vulnificus infection can induce an exacerbation of liver disease, eventually requiring intensive care for multiorgan failure.Patient ConcernsA 56-year-old Chinese male who was admitted for left lower limb swelling 5 days after sustaining an injury. His left lower leg was wounded with a machete used for cutting rubber. Notably, this machete had also been previously utilized for cutting seafood. Blood culture results indicated the presence of V vulnificus during the hospitalization. The patient's condition deteriorated rapidly leading to acute liver failure. Over the ensuing days, the patient experienced separation of tendency of aminotransferase and bilirubin (bilirubin-aminotransferase dissociation), indicative of worsening liver function. Of note, the patient had a history of untreated hepatitis B virus infection and a long drinking history.DiagnosesAcute-on-chronic liver failure following a V vulnificus infection.InterventionsWe utilized double plasma molecular adsorption system (DPMAS) to address the deterioration of the patient's liver function.OutcomesAfter 2 DPMAS treatments, the patient's liver function showed improvement.LessonsThis report underscores the importance of timely and repeated DPMAS treatment of patients with a drinking history or chronic liver disease when they present with V vulnificus septicemia.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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