Vibrio vulnificus is a gram-negative marine bacterium that may cause local wound infection, distinctive soft tissue infection, gastroenteritis and septicaemia with a high mortality rate. A healthy man presented with severe abdominal pain, diarrhoea and fever followed by development of multiple blisters, cellulitis and necrotizing fasciitis of the lower limbs, who progressed rapidly to fulminant sepsis caused by this organism. Vibrio vulnificus septicaemia should be suspected in the presence of sepsis and progressive soft-tissue infection with recent history of raw seafood consumption.
The rarity of acute psychosis in typhoid fever can result in delayed and misdiagnosis of the condition. We report a case of a 20-year-old man who presented with fever and acute psychotic symptoms. This was associated with headache, dizziness, and body weakness. There were no other significant symptoms. Neurological examination revealed reduced muscle tone of bilateral lower limbs but otherwise unremarkable. The computed tomography (CT) scan of his brain showed no abnormality. Blood specimens for microbiological culture grew Salmonella Typhi. This isolate was susceptible to chloramphenicol, ampicillin, ceftriaxone, ciprofloxacin, and trimethoprim-sulfamethoxazole. He was treated with intravenous ceftriaxone for one week and responded well. He was discharged with oral ciprofloxacin for another week. The repeated blood and stool for bacterial culture yielded no growth of Salmonella Typhi.