Vibrio vulnificus Causing Severe Multiorgan Failure in a Patient With Underlying Cirrhosis

Vibrio vulnificus is a marine-associated gram-negative bacillus with the potential to cause severe sepsis. V. vulnificus is classically associated with interactions with shellfish, be it due to inoculation of the bacteria via shell laceration or ingestion of raw shellfish. Patients with underlying liver disease are prone to more severe outcomes associated with V. vulnificus infections. In this case, a male patient in his late 30s with chronic alcohol use disorder presented with acute encephalopathy and hematemesis. History revealed ingestion of raw oysters days prior to presentation. After admission, he developed severe multiorgan failure as well as severe persistent thrombocytopenia. He was started on antibiotic therapy with intravenous ceftazidime and oral doxycycline. He underwent partial splenic embolization with improvement in thrombocytopenia and eventual medical stabilization. It is important for clinicians to recognize classic risk factors for V. vulnificus infection to guide timely diagnosis and management.