[Infection from Baltic Sea water requires extensive mesh-skin transplantation at the University Hospital Ulm].

Vibrio vulnificus (V. vulnificus) is a gram-negative bacterium that can cause severe infections after entering the human body via open wounds or consumption of shellfish. An increased occurrence of bacteria is known at water temperatures > 20 °C. In addition, a low salt content of 5-25‰ is beneficial for the reproduction of Vibrio spp. In the review by Fleischmann et. al. the direct correlation between low salinity and high water temperature with the increased occurrence of V. vulnificus on German Baltic Sea coasts was demonstrated [7]. It can cause fulminant necrotizing fasciitis which can result in amputation, septic shock and death. This case report shows the successful surgical treatment in Germany of a fulminant lower leg infection with septic shock after coming into contact with Baltic Sea water. A rapid and extensive debridement was followed by the successful transplantation of cutaneous tissue using a mesh graft.