Background. Vibrio vulnificus is a marine bacteria associated with the inge
stion of raw shellfish or contact with seawater. It can produce wound infec
tion, diarrhea and sepsis. The main risk factor for infection is the presen
ce of chronic liver disease. Prior studies have shown mortality from 40% to
63%. Objective. Report of 8 cases of disseminated infection with V. vulnif
icus causing fulminant sepsis. Design. Series of cases. Methods. We reviewe
d the database of the laboratory of clinical microbiology from 1990 to 1999
. A computer-based review of the worldwide medical literature was also acco
mplished. Results. There were 8 cases of V. vulnificus infection. All patie
nts had chronic liver disease, 3 also had diabetes mellitus and 1 received
immunosuppressive agents. Five patients were known to have ingested raw she
llfish. The mean duration of illness before death was 4 days. All patients
presented with sepsis, seven had cutaneous lesions. Five patients received
early antimicrobial treatment during the first 24 hours and all of them in
the first 48 hours. Regardless of susceptibility to the antimicrobial agent
s used, the mortality was of 87.5%. Disk-diffusion test showed 100% suscept
ibility to imipenem, ceftazidime and tetracycline; 83% to cefepime, ticarci
llin and cotrimoxazole and 50% to quinolones. Conclusion. The V. vulnificus
infection appears in patients with chronic liver disease and it is associa
ted with high mortality. This infection has to be suspected in high-risk pa
tients who have eaten raw shellfish and therapy must be initiated as soon a
s possible.