Necrotizing fasciitis (NF) caused by vibrio vulnificus (VV) is a rare but fatal clinical emergency characterized by hemorrhagic bullous skin lesions,septic shock and multiple organ dysfunction syndrome (MODS),commonly occurring in patients with chronic liver disease.1,2 In general,mortality of these patients is higher than 60％,which could approach 100％ when complicated with septic shock.Therefore,early diagnosis and effectively surgical intervention in emergency room are the mainstays for better outcomes of these patients.However,many emergency physicians lack experiences in diagnosing and managing vibrio NF.Furthermore,due to the preexisting severe medical complications including hypotension,lactic acidosis,coagulation disorders and thrombocytopenia,the optimal therapeutic strategies for these critical patients should obviously be evaluated on a patient-to-patient basis,which remains largely undefined.