BMJ Case Reports 2017; doi:10.1136/bcr-2017-220199
  • Reminder of important clinical lesson

Vibrio vulnificus septic shock due to a contaminated tattoo

  1. Craig S Glazer
  1. Correspondence to Dr Nicholas Hendren, nicholas.hendren{at}
  • Accepted 13 May 2017
  • Published 27 May 2017


We present a case of Vibrio vulnificus septic shock and cellulitis in a patient with chronic liver disease that occurred after obtaining a leg tattoo with subsequent seawater exposure in the Gulf of Mexico. Initial suspicion for V. vulnificus was high and he was started on empiric doxycycline and ceftriaxone at admission. Blood and wound cultures grew oxidase positive and comma-shaped Gram-negative rods ultimately confirmed to be V. vulnificus. Despite aggressive initial treatment, the patient developed septic shock and died. This case highlights the association of chronic liver disease and high mortality associated with infections of V. vulnificus. Health providers should remain vigilant for V. vulnificus infections in patients with chronic liver disease and raw oyster ingestion or seawater exposure.


  • Contributors NH authored several drafts of the clinical vignette and obtained patient consent. SS edited the drafts and provided feedback in addition to obtaining clinical images. CSG was the senior author who critically reviewed the drafts and verified our citations serving as the guarantor of content. All authors approve the current draft for submission and resume responsibility for the accuracy and integrity of the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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