First description of wound infection with Vibrio harveyi in Spain

MIC, minimum inhibitory concentration; TMP/SMX, trimethoprim/ sulfamethoxazole. Vibrio harveyi (synonym V. carchariae), is a motile Gram-negative rod which is facultatively anaerobic, halophilic and bioluminescent [1]. It is found free-swimming in tropical marine waters and commensally in the gut microflora of marine animals. It is a pathogen of marine animals [2,3], although it has been considered nonpathogenic to humans [4]. To our knowledge, only three previous cases of human infection caused by this bacterium have been reported. The first occurred after a shark bite [5], the second was an episode of catheter-related bacteraemia in a British oncologic paediatric patient with a central line after his return from holiday in Perpignan, France, where he had swum in the sea [6], and the third was a wound mixed infection of Photobacterium damselae and Vibrio harveyi in a German man who, on a trip to west Australia, had experienced a laceration injury to the right tibia after falling from a catamaran [7]. Our case occurred in a 49-year-old man referred from the emergency room for cleaning and debridement of an infected wound in the right pretibial region. One week ago, during a trip to the Dominican Republic, he had experienced trauma from striking a bus step. The wound was sutured, and he was given antibiotic treatment with cefadroxil. He subsequently swam in the sea without protecting the bandage from the seawater. At admission, the patient was afebrile and presented a wound on the front and another on the inside of the distal third of the right leg. He was receiving treatment for ankylosing spondylitis with steroids, infliximab and methotrexate. A wound swab was submitted for microbiologic examination. After overnight incubation, a Gram-negative rod, oxidase positive, was isolated and sent for routine identification and susceptibility testing (MicroScan; Beckman Coulter). The next day, no growth was observed, and tests were repeated, adding NaCl up to a 1% final concentration. MicroScan identified the isolate as Vibrio