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.