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 Original Articles |
| Trial of Intravenous Immunoglobulin and/or Hyperbaric Oxygen Therapy for the Treatment of Suspected Vibrio vulnificus Infection |
| Chan Il Moon, Moon Hyun Chung, Ji Ho Choi |
| Department of Internal Medicine, Chungang Gil Hospital, Inchon, Korea |
Vol.28 Num.3 (p233~238)
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Background : There are reports that intravenous immunoglobulin(IVIG) and hyperbaric oxygen therapy(HBO) show the favorable effects in the management of necrotizing fasciitis. Vibrio vulnificus is one of the important etiologic agents causing necrotizing fasciitis in korea, which results in high mortality and prolonged morbidity. We investigated the effect of IVIG and/or HBO on the mortality of suspected V. vulnificus infection.
Methods : During the summer of 1994, eight patients who were admitted to the Chungang Gil hospital and showed the clinical manifestations suggesting V. vulnificus infections(signs of sepsis; bulla and/or dermal necrosis; and a history of raw seafoods consumption) were enrolled. The enrolled patients were managed with IVIG(12 g/day for 3 days) and/or HBO(3 atm for 2 hours) in addition to the standard treatment including antibiotics)(cefotaxime) and debridement.
Results : Out of eight patients, four patients received IVIG; one patient, HBO; and three patients, both. Trial of hyperbaric oxygen therapy was prematurely ceased because of intolerability in the acute phase and of the occurrence of the barotraumatic otitis in two patients. Among three patients whose cultures revealed V. vulnificus, one patient died on the 14th hospital day. The culture-negative group comprised 5 patients and the outcome was the following; survival, 2 patients; discharge against medical advice, 1 patient; and death, 2 patients.
Conclusion : The effect of IVIG and/or HBO on the overall mortality was not meaningfully different from the results of other reports, but there seemed to be an effect in decreasing the early death. Further studies are needed to confirm the efficacy of this therapeutic trial.
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Keywords : Necrotizing fasciitis, Vibrio vulnificus, Intravenous immunoglobulin, Hyperbaric oxygen therapy |
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