V. damsela has been reported to cause skin ulcers and fatal disease in damselfish (15). It was isolated from a brown shark that died in captivity and was shown to be lethal when injected into spiny dogfish (19). Pederson et al. (68) isolated it from diseased fish rainbow trout, stingrays, and nurse shark in Denmark. Various reports describe the ability of the pathogen to cause infections in bottle-nose dolphins, leatherback turtles, seabream, cultured sea bass, and cultured turbot (69-73).
In humans, V. damsela has been associated only with wound infections. Morris et al. (39) described the case histories of six patients who did not have any underlying disease but had wound infections from which the pathogen was isolated. Wounds in four of the six cases were erythematous, indurated, and had purulent discharge. None of the cases showed necrosis, fasciitis, or serious drainage. Wounds in five of the cases required surgical debridement. Three of the six patients had to be hospitalized. All the patients recovered completely. Two hemolytic variants of the pathogen were associated with a fatal wound infection in an alcoholic man who had an underlying history of pancreatitis and insulin dependency (74). A mild superficial wound infection progressed into marked edema of the forearm and bullae formation on the hand. The patient underwent surgery but later died because of additional complications such as disseminated intravascular coagulation, acute renal failure, and hypercalcemia. Coffey et al. (75) reported the case of another diabetic who acquired an infection through a wound in a finger. The disease rapidly progressed to a swelling of the entire hand and arm. The arm had to be amputated at the shoulder. V. damsela could be isolated from both the wound and the blood in a case of fulminant septicemia in a 70-year-old man who had a history of mitral valve replacement and coronary artery bypass (76). The wound on the finger developed into a swelling of the entire arm that had erythema and hemorrhagic bullous lesions. Following surgical debridement, the patient suffered from oligouric renal failure, acidosis, jaundice, and disseminated intravascular coagulation and died on the third day of hospitalization. The pathogen was isolated from the blood and necrotic tissue of a 63-year-old male who had diabetes mellitus and alcoholic liver disease (77). However, in this case, infection was acquired through consumption of raw eels and not through a wound infection. Initial swelling and erythema on the arm appeared approximately 24 hours after consumption of the eel and led to the development of bullae on the lower arm and of necrosis, which then spread to the upper arm. The patient lost consciousness, exhibited signs of septic shock and intravascular hemolysis, and died 2.5 hours after arrival in a hospital. A 64-year-old man with a history of atherosclerotic heart disease and ventricular arrhythmias acquired a fatal infection through an injury on the hand (78). Examination of the swollen hand was remarkable for erythema and profound edema of the medial right hand. The hand was debrided and irrigated, but the patient died. Another case of fatal necrotizing fasciitis was described by Yuen et al. (79). The patient did not have any underlying condition and died after surgery.
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Rosacea and Eczema are two skin conditions that are fairly commonly found throughout the world. Each of them is characterized by different features, and can be both discomfiting as well as result in undesirable appearance features. In a nutshell, theyre problems that many would want to deal with.