Warning – this story contains images that may be disturbing to some readers.
A Korean man had to have his arm amputated after eating a seafood meal, according to a case report in the New England Journal of Medicine.
The 71-year-old man arrived at the emergency department after experiencing two days of fever and excruciating pain in his left hand. His symptoms had developed 12 hours after he ate raw seafood.
By the time he was at the hospital, a purple bubble-like swelling measuring 3.5 centimetres by 4.5 centimetres had developed on the palm of his hand. The back of his hand and forearm had swollen too and were similarly discoloured.
Doctors performed surgery on the man’s hand, and after testing the swollen areas, they found the bacteria Vibrio vulnificus – one of a few species otherwise known as flesh-eating bacteria.
Most people get infected with V. vulnificus by eating raw or undercooked shellfish, especially raw oysters, according to the U.S. Centers for Disease Control. Some people also get it if they get brackish water in an open wound. Between 15 and 30 per cent of infections are fatal, says the CDC.
In this case, the man survived – though not unscathed.
After his initial surgery, doctors gave him antibiotics. However, despite this treatment, the skin lesions progressed to “deep, necrotic ulcers” and 25 days after he arrived in hospital, doctors decided to amputate his left forearm.
Warning – the images below may be disturbing to some viewers.
The man’s infection may have gotten worse because he already had diabetes, hypertension, and end-stage kidney disease, for which he was on dialysis. As the NEJM article states, patients with immunocompromising conditions are at increased risk for infection and complications.
Anyone can get sick from V. vulnificus, says the CDC, but people with liver disease, cancer, diabetes, HIV or thalassemia are more likely to develop complications. People who receive immune-suppressant drugs or take medicine to reduce stomach acid are also at higher risk.
The CDC recommends cooking all shellfish before eating it, including oysters. Hot sauce and lemon juice won’t cut it, they say, and drinking alcohol along with your shellfish won’t kill the bacteria either.
Vibrio vulnificus causes about 205 infections in the United States each year, according to the CDC.
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