JAMA : the journal of the American Medical Association
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Vibrio parahaemolyticus is an extremely common organism of major importance as a cause of gastroenteritis, but not common as a cause of tissue infection. Of three patients who had serious localized tissue infections, one died because of an unnamed marine Vibrio infection. ⋯ It is hoped that agreement can be reached as to bacteriologic genealogy; perhaps then the specific pathogenic manifestations will be clarified. The clinician should consider the possibility of this pathogen in any patient with a wound related to saltwater or seafood.
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Gangrenous lesions accompanied by evidence of subcutaneous gas usually are diagnosed as "clostridial gas gangrene." The occurrence of nonclostridial gas gangrene has been infrequently reported and is thought to be relatively rare. Review of 278 admissions of diabetic patients with orthopedic vascular problems disclosed a 17% (48 patients) incidence of nonclostridial gas infections and a 3% (one patient) occurrence of clostridial gas gangrene. Clinical characteristics ranged from severe to benign toxicity. Appreciation of the causative organisms (usually mixed Gram-negative rod and enterococcus) of this syndrome is essential, especially in the diabetic patient, since appropriate antibiotic therapy and surgery can result in a low mortality (4%) and a high incidence (80%) of ambulatory, independent patients.