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Case Reports in Medicine
Volume 2013, Article ID 610632, 7 pages
http://dx.doi.org/10.1155/2013/610632
Case Report

Severe Wound Infection with Photobacterium damselae ssp. damselae and Vibrio harveyi, following a Laceration Injury in Marine Environment: A Case Report and Review of the Literature

1Gemeinschaftspraxis für Orthopädie, Chirurgie, Unfallchirurgie Sportmedizin, Manuelle Medizin/Chiropraktik, Theodor Heuss Straße 1, 78467 Konstanz, Germany
2Laboratory of Dr. Brunner, Mainaustraße 48 a/b, 78464 Konstanz, Germany
3Department of Medical Microbiology and Molecular Microbiology, Laboratory of Dr. Brunner, Mainaustraße 48 a/b, 78464 Konstanz, Germany

Received 18 June 2013; Revised 20 August 2013; Accepted 21 August 2013

Academic Editor: Jacques F. Meis

Copyright © 2013 Jörg Hundenborn et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Marine microorganisms are uncommon etiologies of skin and skin structure infections, that is, wound infections. We report a case of severe wound infection, caused by the marine Photobacterium damselae (Vibrionaceae), in a 64-year-old male patient, returning from Australia. The isolate tested positive for pPHDD1, a plasmid conferring high-level virulence. Furthermore, the wound was coinfected with Vibrio harveyi, a halophile bacterium, which has never been reported from human infections before. Identification was achieved by use of Matrix-Assisted Laser Desorption-Ionization Time of Flight Mass Spectrometry (MALDI-TOF) and confirmed by 16S rDNA sequencing. Data retrieval from bibliography was complicated since P. damselae has been renamed often with a number of synonyms present in the literature: Photobacterium damsela, Vibrio damselae, Vibrio damsela, Pasteurella damselae, and Listonella damsela. With all synonyms used as query terms, a literature search provided less than 20 cases published worldwide. A majority of those cases presenting as severe wound infection are even fatal following progression into necrotizing fasciitis. Management with daily wound dressing and antibiotic therapy (ofloxacin empirically, followed by doxycycline after availability of microbiology) led in the reported case to a favorable outcome, which seems to be, however, the exception based on a review of the available literature.