A middle age Caucasian gentleman presented to the Emergency Department with fever, chills and hypotension. Chest X-ray revealed consolidation in right lower lobe consistent with pneumonia. A chest radiograph after central line placement revealed a venous anomaly. CT scan with contrast revealed persistent left superior vena cava and absent right superior vena cava.

We present the case and images of a 52 yearold Hispanic gentleman with a history of hepatitis C and chronic liver disease that developed Vibrio vulnifi cus sepsis secondary to eating raw oysters.
His course was complicated by necrotizing fasciitis in the upper extremities and renal failure.