173.4 📌 章末速記

• Vibrio — gram - curved, oxidase +, alkaline-tolerant
• V. cholerae: rice-water 大量水瀉, no fever/pain/blood → ORS + doxy/azithro
• V. parahaemolyticus: 海鮮 gastroenteritis, self-limit
• V. vulnificus: cirrhotic + raw oyster → primary septicemia; 海水 wound → NF; EMERGENT doxy + ceftriaxone + debridement
• 全球 cholera pandemic 7 持續 (Haiti, Yemen, Pakistan flood, Syria, Lebanon)
• 暖海水 + climate change = V. vulnificus 北擴
• Vaccines: Dukoral, Shanchol, Euvichol-Plus (WHO)
• 盧醫師 hint: cirrhotic + raw oyster → 必 educate; sepsis + 海水接觸 → V. vulnificus until R/O