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Retired NBME 18 Answers

nbme18/Block 1/Question#34 (reveal difficulty score)
60 yo man, 1 day of fever, chills, confusion ...
Vibrio vulnificus ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—sinforslide(63)
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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."

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sinforslide  Also see UWORLD ID: 15255 +4
suckitnbme  Vibrio species are mostly non-lactose fermenters except Vibrio vulnificus +8
motherhen  I thought V.vulnificus could only cause food poisoning from eating shellfish; turns out contact with wound infections causes it too (hence why walking barefoot on the beach is a risk factor) +3
ootscoot  I think they threw this one in here for all the Sketchy loyalists. Gotta keep us on our feet. +3



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