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NBME 18 Answers

nbme18/Block 1/Question#34

60 yo man, 1 day of fever, chills, confusion and memory loss

Vibrio vulnificus

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The patient walked barefoot on the beach and had cirrhosis, which makes him vulnerable for V. vulnificus bacteremia. V. vulnificus bacteremia has a very poor prognosis.

From Uptodate: "[V. vulnificus] is the leading cause of shellfish-associated deaths in the United States. Infections due to V. vulnificus are most common in individuals who have chronic, underlying illness; individuals with liver disease or hemochromatosis are at greatest risk."

sinforslide  Also see UWORLD ID: 15255 +