The prognosis for non-cholera Vibrio infections varies with underlying comorbidity and the clinical presentation of the infection.
Vibrio parahaemolyticus-associated gastroenteritis
In people without any underlying comorbidity, this is usually a self limiting diarrheal illness lasting 1-7 days.[10]California Department of Public Health. CDPH IDB guidance for managing select communicable diseases: non-cholera Vibrio infections. Jun 2023 [internet publication].
https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/IDBGuidanceforCALHJs-Vibriosis.pdf
[62]Bell A, Bott M. Vibriosis: what you and your patients need to know. Dela J Public Health. 2021 Jan 21;7(1):14-21.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8352540
http://www.ncbi.nlm.nih.gov/pubmed/34467175?tool=bestpractice.com
Vibrio alginolyticus soft-tissue infection
This is often a self-limiting skin infection occasionally requiring a short course of oral antibiotic therapy.[28]Tantillo GM, Fontanarosa M, Di Pinto A, et al. Updated perspectives on emerging vibrios associated with human infections. Lett Appl Microbiol. 2004;39:117-26.
http://www.ncbi.nlm.nih.gov/pubmed/15242449?tool=bestpractice.com
[39]Baker-Austin C, Oliver JD, Alam M, et al. Vibrio spp. infections. Nat Rev Dis Primers. 2018 Jul 12;4(1):8. [Erratum in: Nat Rev Dis Primers. 2021 Feb 19;7(1):15.]
https://www.nature.com/articles/s41572-018-0005-8
http://www.ncbi.nlm.nih.gov/pubmed/30002421?tool=bestpractice.com
Vibrio vulnificus infection
Primary septicemia has a higher case-fatality rate (28%) than wound infection (8%). Admission APACHE II scores of greater than 15 correlate with mortalities >50%.[63]Chou TN, Lee YT, Lai YY, et al. Prognostic factors for primary septicemia and wound infection caused by Vibrio vulnificus. Am J Emerg Med. 2010;28:424-31.
http://www.ncbi.nlm.nih.gov/pubmed/20466220?tool=bestpractice.com
Similarly, a Rapid Emergency Medicine Score (REMS) of 8 or more was significantly associated with increased mortality risk.[64]Kuo SH, Tsai CF, Li CR, et al. Rapid Emergency Medicine Score as a main predictor of mortality in Vibrio vulnificus-related patients. Am J Emerg Med. 2013;31:1037-41.
http://www.ncbi.nlm.nih.gov/pubmed/23702054?tool=bestpractice.com
A delay in presentation to the emergency department of greater than 3 days after injury or symptom onset is a predictor of increased mortality rate (13% if 3 days or fewer versus 55.6% if greater than 3 days).[65]Lee YC, Hor LI, Chiu HY, et al. Prognostic factor of mortality and its clinical implications in patients with necrotizing fasciitis caused by Vibrio vulnificus. Eur J Clin Microbiol Infect Dis. 2014;33:1011-8.
http://www.ncbi.nlm.nih.gov/pubmed/24419406?tool=bestpractice.com
Septic shock with associated necrotizing soft-tissue infection has a mortality estimated at 23% compared with patients undergoing early fasciotomy and without shock of 4.9%.[55]Kuo YL, Shieh SJ, Chiu HY, et al. Necrotizing fasciitis caused by Vibrio vulnificus: epidemiology, clinical findings, treatment and prevention. Eur J Clin Microbiol Infect Dis. 2007;26:785-92.
http://www.ncbi.nlm.nih.gov/pubmed/17674061?tool=bestpractice.com
Admission to the hospital may be complicated by prolonged intensive care unit stays, multiple surgical procedures for debridement of devitalized tissue, and possible limb amputation.
Hypoalbuminemia of <2 g/dL statistically correlates with the outcome of death or major amputation.[56]Huang KC, Hsieh PH, Huang KC, et al. Vibrio necrotizing soft-tissue infection of the upper extremity: factors predictive of amputation and death. J Infect. 2008;57:290-7.
http://www.ncbi.nlm.nih.gov/pubmed/18755513?tool=bestpractice.com
Patients admitted to the intensive care unit with necrotizing cellulitis or fasciitis, skin or soft tissue involvement of 2 or more limbs, or high APACHE II scores have significant risk of mortality.[57]Chen S, Chan K, Chao W, et al. Clinical outcomes and prognostic factors for patients with Vibrio vulnificus infections requiring intensive care: a 10 year retrospective study. Crit Care Med. 2010;38:1984-90.
http://www.ncbi.nlm.nih.gov/pubmed/20657269?tool=bestpractice.com