An unusual case of sepsis with both Vibrio vulnificus and Enterococcus casseliflavus.

An 87-year-old man with metastatic prostate cancer on prior dexamethasone and chemotherapy presented to the emergency department with fever, hypotension and diarrhea. Blood cultures at the time of admission revealed both Vibrio vulnificus and Enterococcus casseliflavus. Raw oysters harvested from a Louisiana marsh were consumed 12 and 13 days pre-admission. V. vulnificus sepsis typically manifests within one to three days of exposure, though prior reports have indicated infections as late as seven days later. These bacteria particularly grow in warmer saline waters, and infections are less common in winter. Warming trends in US weather and in particular warming trends in the coastal marshes where oysters are grown and harvested may create less seasonal variation and higher rates of Vibrio infection.