Background: Aeromonas hydrophila (AH) is a rare gram-negative anaerobic bacterium that is usually found in freshwater and contaminated soils. AH may behave in a pathogenic manner and a majority of the literature reports clinical manifestations of significant infection – typically in the immunocompromised. However, recent genomic typing of the bacterium has led to the discovery of a less virulent but antibiotic resistant strain which may be responsible for colonisation rather than infection. Case report: We present an example of successful graft uptake in the presence of heavy graft site growth of Aeromonas hydrophila. Discussion: Contemporary literature is yet to make the distinction between colonisation and infection of this bacterium, with clinicians relying solely on the presence of infective stigmata and serum analysis. However, this is a critically important distinction when ascertaining the likelihood of success of wound healing.