Recovery from Marine Vibrio Infection After Fish Sting: A Patient's Journey

I am currently abroad and would like to inquire about the recovery situation for Vibrio parahaemolyticus infections?

Hello Doctor, I am currently in Oman (as of February 15).
On February 11 at 3 PM, while diving to catch fish, I accidentally got stung on the back of my hand by a catfish (sand catfish).
The sting felt like it hit a tendon and was extremely painful and numb at the moment, approximately 3mm deep.
I immediately swam back to shore and soaked my hand in hot water, only managing to squeeze out blood without extracting the spine.
After the sting, my entire arm was in severe pain and weakness, making it almost impossible to move.
I thought I could endure it since it wasn't from a highly venomous fish.
The next morning, the pain intensified; the sting site was less painful, but the surrounding joints and muscles felt like they were tearing apart.
At 1 PM, I suspected an infection from Vibrio species and went to the local hospital for emergency care (at that time, I could move my arm, but my hand was almost immobile).
The hospital administered an injection in my buttocks, an IV in my arm, and prescribed an antibiotic, an antihistamine, and a topical ointment.
After the first night, my hand was mostly pain-free (I could move my fingers slightly), but it was more swollen.
The next day, the swelling was similar, with pain upon pressure (similar to a bruise, but I could grip my hand more effectively).
By the third day, I regained about 70% strength in my thumb and two fingers on the right side of my palm, but my index and middle fingers felt stiff and painful when bending, resembling a pulling sensation.
However, I was able to drive (as I needed to travel 600 kilometers back to the capital).
After showering at home, I noticed a bruise-like sensation in my palm, and the back of my hand was painful to the touch.
I'm unsure if this indicates worsening or healing.
Since I am flying to Germany on the 19th, I would like to ask if I should see a doctor again for more antibiotics or other treatment.
The doctor prescribed a 5-day course of antibiotics, but I received a 7-day supply.
Below are the medication list and images of the affected area.
Thank you, Doctor.

You, 30~39 year old female. Ask Date: 2023/02/15

Dr. Hong Yuanbin reply Internal Medicine

Hello, the antibiotic you were prescribed is a first-generation antibiotic for general cellulitis.
However, based on your images, it does appear to have improved.
As for the pain or pigmentation changes, these are likely residual symptoms of cellulitis.
Please be cautious and check for any signs of pus.
A way to assess this is by gently pressing on the affected area: if it feels solid and firm, it is less concerning.
However, if it feels like there is a fluid-filled sac underneath, you should seek medical attention promptly.
Additionally, if you experience increasing redness, swelling, heat, or pain, it is also advisable to see a doctor.
Thank you for your inquiry.

Reply Date: 2023/02/15

More Info

Recovering from a marine Vibrio infection after a fish sting can be a complex process, especially when considering the symptoms and treatments involved. Based on your detailed account, it seems you experienced a significant injury from a catfish sting, which led to immediate pain and subsequent medical intervention. Here’s a comprehensive overview of your situation and the considerations for your recovery.

Initial Injury and Symptoms
You described being stung by a catfish, which can indeed cause intense pain and localized swelling. The immediate response of soaking the wound in hot water is a common first aid measure, as it can help alleviate pain and potentially neutralize some toxins. However, it’s crucial to understand that while this may provide temporary relief, it does not address the risk of infection, particularly from marine bacteria such as Vibrio species.

Medical Intervention
Upon visiting the emergency department, you received antibiotics and antihistamines, which are appropriate treatments for managing pain and preventing infection. The fact that your pain decreased significantly after the first night suggests that the initial treatment was effective. However, the swelling and bruising you observed are concerning and indicate that inflammation is still present, which can be a normal part of the healing process but can also signal complications.

Recovery Timeline
Your recovery appears to follow a typical pattern for soft tissue injuries, where pain and swelling peak before gradually subsiding. The fact that you regained some function in your fingers is a positive sign. However, the lingering pain and stiffness, particularly in your index and middle fingers, warrant careful monitoring. This could be due to residual inflammation or even a potential infection that has not fully resolved.

Risk of Vibrio Infection
Given your concern about a Vibrio infection, it’s important to note that these bacteria are typically associated with wounds exposed to seawater or contaminated seafood. Symptoms of a Vibrio infection can include increased redness, swelling, warmth, and pus formation at the site of injury. If you notice any of these signs, or if your symptoms worsen, it is crucial to seek medical attention promptly.

Recommendations
1. Monitor Symptoms: Keep a close eye on the affected area for any signs of worsening infection, such as increased redness, swelling, or discharge. If you experience fever or chills, these could also indicate a systemic infection.

2. Follow-Up Care: Since you have a flight to Germany on the 19th, it would be wise to consult with a healthcare provider before your departure. They may recommend extending your antibiotic course or switching to a different medication if they suspect an infection.

3. Pain Management: Continue to manage pain with over-the-counter pain relievers as needed, and consider gentle range-of-motion exercises to prevent stiffness in your fingers.

4. Hydration and Nutrition: Ensure you are well-hydrated and consuming a balanced diet to support your immune system during recovery.

5. Avoid Further Injury: Be cautious with the affected hand to avoid aggravating the injury, especially during travel.

Conclusion
Your journey through recovery from a marine Vibrio infection after a fish sting highlights the importance of prompt medical care and ongoing monitoring of symptoms. While your initial treatment seems effective, vigilance is key to ensuring complete recovery. If you have any doubts or if your condition changes, do not hesitate to seek medical advice. Safe travels to Germany, and I hope for a smooth recovery ahead!

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