A description and illustration of a necrotizing fasciitis by John Bell in 1801, hypothetically caused by Vibrio vulnificus

We present an overlooked and noteworthy historical case and illustration of a necrotizing fasciitis, observed and written by John Bell (1763-1820), first published in 1801. Considering the setting and the clinical presentation, we hypothesize that the pathogen responsible was the species Vibrio vulnificus. The typical clinical course of a rapidly progressive illness preceded by saltwater exposure shortly followed by the development of a hemorrhagic skin lesion, with a fatal outcome, should strongly suggest a V. vulnificus infection. To our knowledge, there are few historical case reports with illustrations included describing cases of necrotizing fasciitis, particularly with V. vulnificus as the suggested pathogen. (C) 2010 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.