VEXAS Syndrome with Vibrio vulnificus Sepsis during Treatment with Tocilizumab

Abstract

We report the first case of Vibrio vulnificus sepsis in a patient with vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) syndrome. A 76-year-old man was diagnosed with VEXAS and myelodysplastic syndromes. He was treated with tocilizumab, oral prednisolone, and regular blood transfusions. The patient presented with fever, chills, and vomiting and was subsequently diagnosed with sepsis. A blood culture confirmed V. vulnificus infection, which resolved after tazobactam/piperacillin treatment. V. vulnificus infections can be facilitated by iron overload resulting from frequent blood transfusions. Since patients with VEXAS syndrome often require regular transfusions, clinicians should monitor for this potentially fatal infection.

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BibTeX RIS

BibTeX

@article{kawakami2026vexas,
  title = {{VEXAS Syndrome with Vibrio vulnificus Sepsis during Treatment with Tocilizumab}},
  author = {Eiko Kawakami and Takahisa Suzuki and Sousuke Tsuji and Takeharu Kato and Kuniko Abe and Tomohiro Koga and Atsushi Kawakami},
  journal = {Internal Medicine},
  year = {2026},
  month = aug,
  doi = {10.2169/internalmedicine.6479-25},
  url = {https://www.jstage.jst.go.jp/article/internalmedicine/65/16/65_6479-25/_article},
  note = {CC BY-NC-ND},
}

RIS

TY  - JOUR
TI  - VEXAS Syndrome with Vibrio vulnificus Sepsis during Treatment with Tocilizumab
AU  - Eiko Kawakami
AU  - Takahisa Suzuki
AU  - Sousuke Tsuji
AU  - Takeharu Kato
AU  - Kuniko Abe
AU  - Tomohiro Koga
AU  - Atsushi Kawakami
PY  - 2026
DA  - 2026/08/15
JO  - Internal Medicine
DO  - 10.2169/internalmedicine.6479-25
UR  - https://www.jstage.jst.go.jp/article/internalmedicine/65/16/65_6479-25/_article
AB  - We report the first case of Vibrio vulnificus sepsis in a patient with vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) syndrome. A 76-year-old man was diagnosed with VEXAS and myelodysplastic syndromes. He was treated with tocilizumab, oral prednisolone, and regular blood transfusions. The patient presented with fever, chills, and vomiting and was subsequently diagnosed with sepsis. A blood culture confirmed V. vulnificus infection, which resolved after tazobactam/piperacillin treatment. V. vulnificus infections can be facilitated by iron overload resulting from frequent blood transfusions. Since patients with VEXAS syndrome often require regular transfusions, clinicians should monitor for this potentially fatal infection.
SN  - 1349-7235
SN  - 0918-2918
ER  -

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