Cellulitis left lower leg secondary to Pseudomonas aeruginosa bacteremia: case of community -acquired infection
Keywords:Cellulitis, Limb infection, Pseudomonas cellulitis, Pseudomonas infection
The term cellulitis is commonly used to indicate a nonnecrotizing inflammation of the skin and subcutaneous tissues, usually from acute infection. Pseudomonas aeruginosa is a gram-negative bacillus that causes wide spectrum clinical infections. However, it is most frequently associated with hospital-acquired infection. Authors are presenting a case report of 45 years old Saudi male who presented initially with redness and hotness in the mid of right lower leg gradually increased with development of vesiculous bullae, scaling and sloughing of overlying skin. Pseudomonas aeruginosa was identified from the case, though it was not a usual suspected organism. It might be due to community-acquired infection. Patient was treated conservatively with I/V antibiotic and local hygienic methods including dressing with vaseline (bactigrass) and topical antibiotics. Patient improved and discharged with complete resolution of cellulitis
Roujeau JC, Sigurgeirsson B, Korting HC, Kerl H, Paul C. Chronic dermatomycoses of the foot as risk factors for acute bacterial cellulitis of the leg: a case-control study. Dermatol. 2004;209(4):301-7.
Björnsdóttir S, Gottfredsson M, Thórisdóttir AS, Gunnarsson GB, Ríkardsdóttir H, Kristjánsson M, et al. Risk factors for acute cellulitis of the lower limb: a prospective case-control study. Clin Infect Dis. 2005. 41(10):1416-22.
Roberts S, Chambers S. Diagnosis and management of Staphylococcus aureus infections of the skin and soft tissue. Intern Med J. 2005;(Suppl 2):S97-105.
Kroshinsky D, Grossman ME, Fox LP. Approach to the patient with presumed cellulitis. Semin Cutan Med Surg. 2007 Sep; 26(3):168-78.
Pollack M. Pseudomonas Aeruginosa. Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. New York, NY: Churchill Livingstone; 2000:2310-2327.
Hadi U, Chaar M, Jaafar RF, Matar GM. Comparative analysis of hospital acquired and community acquired Pseudomonas aeruginosa strains in tertiary care medical center. J Appl Res. 2007;7:233-7.
Vitkauskiene A, Skrodeniene E, Dambrauskiene A, Macas A, Sakalauskas R. Pseudomonas aeruginosa bacteremia: resistance to antibiotics, risk factors, and patient mortality. Medicina (Kaunas) 2010;46:490-5.
Parkins MD, Gregson DB, Pitout JDD, Ross T, Laupland KB. Population-based study of the epidemiology and the risk factors for Pseudomonas aeruginosa bloodstream infection. Infection. 2010;38:25-32.
Fazlul MKK, Zaini MZ, Rashid MA, Nazmul MHM. Antibiotic susceptibility profiles of clinical isolates of Pseudomonas aeruginosa from Selayang Hospital, Malaysia. Biomed Res. 2011;22:263-266.
Tam VH, Chang KT, Schilling AN, La Rocco MT, Genty LO, Garey KW. Impact of AmpC overexpression on outcomes of patients with Pseudomonas aeruginosa bacteremia. Diagn Microbiol Infect Dis. 2009;63:279-85.
Schechner V, Nobre V, Kaye KS, Leshno M, Giladi M, Rohner P, et al. Gram-negative bacteremia upon hospital admission: When should Pseudomonas aeruginosa be suspected? Clin Infect Dis. 2009;48:580-6.
Dryden MS. Skin and soft tissue infection: microbiology and epidemiology. Int J Antimicrob Agents. 2009;34:S2-S7.
Giamerellou H. Therapeutic guideline for Pseudomonas aeruginosa infections. Int J Antimicrob Agents. 2000;16:103-6.
Horino T, Chiba A, Kawano S, Kato T, Sato F, Maruyama Y, et al. Clinical characteristics and risk factors for mortality in patients with bacteremia caused by Pseudomonas aeruginosa. Intern Med. 2012;51:59-64.