Severe Shewanella Cellulitis Following Saltwater Exposure in an Elderly Patient.

Shewanella algae is an opportunistic Gram-negative bacillus primarily found in marine environments. It can cause a range of infections in humans, from superficial soft tissue infections to more severe conditions like bacteremia, otitis, and hepatobiliary infections. While infections are rare, they can be significant, leading to complications such as sepsis and tissue necrosis. We present the case of severe cellulitis caused by Shewanella in an 88-year-old patient with multiple comorbidities. Following a blue crab pinch and consequent saltwater exposure, the patient developed severe cellulitis, sepsis, delirium, and atrial fibrillation. Despite these complications and the patient's age, a prompt diagnosis and a combination of antibiotic treatments led to a successful recovery. This case is notable for its illustration of the potential severity and diverse clinical presentation of Shewanella infections. It highlights the importance of considering Shewanella as a possible pathogen in cases of saltwater exposure and teaches management in elderly, multi-morbid patients.

Acute Paraplegia Caused by Spinal Epidural Empyema Following Infectious Cellulitis of the Hand: Case Report and Literature Review.

Background Spinal epidural abscess is a rare but serious condition that can cause spinal cord compression and neurological deficits. Case Description and Methods The article reports a case of a 31-year-old patient who presented with an infectious cellulitis in the left hand, which progressed to a spinal epidural abscess. The diagnosis was confirmed by clinical examination and magnetic resonance imaging. Treatment involved laminectomy, after which the patient had complete recovery of neurological deficits. This article is a case report with a literature review. Patient data and images were collected by the researchers who participated in the patient's care. The literature was reviewed by one of the researchers based on the search for articles in the PubMed database. For the research, the following keywords were inserted: "Spinal epidural empyema," "Spinal epidural abscess." Conclusion Spinal epidural abscess is often underdiagnosed, which can lead to delays in treatment and serious complications. The relationship between cellulitis and spinal epidural abscess may be related to the spread of infection through the lymphatic or blood system.

An Infected Dog Bite With Neisseria canis: A Case Report and Review of the Literature.

Neisseria is a common bacteria that colonizes in humans. Of the 11 species, only two, N. meningitidis and N. gonorrhea, are pathogenic. Although sparse, there are case reports of other Neisseria species causing infections in humans. Neisseria canis, which is a part of normal flora in the mouths of dogs and cats, has been shown to have potential to be pathogenic in humans. The standard treatment for dog and cat bites is oral amoxicillin/clavulanic acid (Augmentin) or IV ampicillin/sulbactam (Unasyn). However, in cases where the patient has multiple antibiotic allergies, careful antibiotic selection must be made to ensure resolution of infection.

Pemetrexed-Induced Pseudocellulitis: A Diagnostic Conundrum.

Pemetrexed, an anti-folate, antineoplastic agent, effectively treats various malignancies such as non-small cell lung cancer (NSCLC) and mesothelioma. Here, we report two cases of recurrent pemetrexed-induced lower extremity erythema and edema, one in a 60-year-old male and the other in a 47-year-old male, who were both treated for recurrent cellulitis on multiple occasions before finally being diagnosed with pemetrexed-induced pseudocellulitis (PIP), a rarely reported adverse effect. This is an important diagnostic pitfall for clinicians to be aware of, as early recognition may minimize patient morbidity and prevent unnecessary hospitalization and antibiotic use for presumed cellulitis.

Clinical Entity Mimicking Infectious Cellulitis: Eosinophilic Cellulitis (Wells' Syndrome).

Eosinophilic cellulitis (EC) is a skin disease characterized by pruritic, non-purulent, erythematous plaques and histologically by edema and eosinophil infiltration in the dermis. The etiopathogenesis of the disease is not fully elucidated. It differs from infectious cellulitis by being unresponsive to antibiotics and recurring. This case report presents a late-diagnosed case of EC in a patient who did not respond to long-term and broad-spectrum antibiotics. This case underscores the importance of skin biopsy and histopathological diagnosis in patients with recurrent, non-responsive, antibiotic-resistant, and cellulitis-like clinical features resembling infectious cellulitis; "eosinophilic cellulitis" should be considered in the differential diagnosis.

Síndrome de Nicolau: A propósito de un caso / Nicolau syndrome: About a case

Se evaluó paciente femenino de 51 años, con antecedentes de diabetes mellitus tipo II e infecciones urinarias a repetición, procedente de la comunidad Mario Briceño Iragorry, quien acude al ambulatorio centro de especialidades "Los Grillitos", de la Corporación de Salud del Estado de Aragua - Venezuela, presentando lesión ulcerada a nivel de hemicadera izquierda, posterior a la colocación vía intramuscular de diclofenac sódico el 28/03/17, el que fue indicado por facultativo para tratar dolor por infección urinaria alta. Posteriormente, a las 24 horas presenta en la zona de la inyección una coloración violácea, induración y mucho dolor, motivo por el que acude nuevamente al facultativo. Se le realizó ecosonograma de partes blandas en región glútea izquierda, reportando imagen heterogénea a predominio hipoecoico con ecos internos de mediana intensidad, que genera reforzamiento posterior de 49x39 mm, con aproximadamente 30 cc de líquido, que correspondería a un proceso inflamatorio e infeccioso (absceso). Posteriormente a la evaluación, se indica antibiótico terapia a base de oxacilina 1 g cada 8 horas vía endovenosa por siete días, además 100 mg cada 12 horas vía oral de nitrofurantoína para el proceso infeccioso urinario, que el urocultivo indica ser sensible a la E. Coli. Al tercer día de la enfermedad actual, se le drena absceso con material purulento aproximadamente 20 cc y cura sucesiva por cinco días, evolucionando satisfactoriamente del proceso infeccioso de partes blandas e infección urinaria.

A 51-year-old female patient with a history of type II diabetes mellitus and recurrent urinary tract infections from the Mario Briceño Iragorry community, attended the outpatient clinic "Los Grillitos" of the health corporation of Aragua Venezuela, with an ulcerated lesion at the left hemi-hip level, following the intramuscular placement of diclofenac sodium on 03/28/17, which was indicated by facultative to treat pain due to high urinary tract infection, afterwards approximately 24 hours presents at the injection site a violet coloration, induration and a lot of pain, which is why she returned to facultative, she performed a soft-tissue echosonogram in the left gluteal region reporting a heterogeneous image to hypoechoic predominance with internal echoes of medium intensity that generates posterior reinforcement which measures 49x39 mm with approximately 30 cc of liquid that could correspond to an inflammatory and infectious process (abscess), post-evaluation is indicated antibiotic therapy based on oxacillin 1 g every 8 hours intravenous route for seven days plus 100 mg every 12 hours oral route of nitrofurantoin for the urinary infectious process that the urine culture indicates to be sensitive E. coli, the third day of illness is drained abscess purulent material approximately 20 cc and successive cure for five days. Satisfactory evolution of the infectious process of soft tissue and urinary tract infection.

Síndrome de Nicolau: a propósito de un caso / Nicolau Syndrome: About a case

Comunicamos una paciente femenina de 24 años de edad, natural y procedente de la localidad, quien consulta en el mes de enero de 2016 al Centro Integral de Especialidades “Los Grillitos”, CORPOSALUD. Municipio Mario Briceño Iragorry por presentar lesión ulcerosa a nivel de hemicadera derecha, cuya aparición fue posterior a la administración de medicamentos vía intramuscular (ampolla de amikacina). El tratamiento aplicado fue debido a una infección vaginal que presentó en el mes de septiembre 2015, cuyo cultivo resultó sensible a este antibiótico; comenzó a presentar un área endurecida color violáceo, hasta convertirse en una úlcera en el mes de diciembre 2015. Por este motivo, acude al médico quien indica ecosonograma de partes blandas (27/1/2016), informando: úlcera de 29 mm asociado a celulitis post infecciosa a administración medicamentosa, en hemicadera derecha y hematoma, organizado en hemicadera izquierda (0,25 cc); se realiza cultivo (27/1/2016) reportando presencia de Acinetobacter baumani complex sensible a la ciprofloxacina, la que se indica, observándose actualmente mejoría clínica de la lesión.

It is 24 years female patient age and naturally from the locality, who consults in January 2016 to Integral Center Specialty "The Grillitos" Corposalud. Municipio Mario Briceño Iragorry to present Injury ulcer type level right hemi hip whose appearance was after drug administration (vial amikacin) treatment applied due to a vaginal infection present in the month of September 2015 whose culture was sensitive to this antibiotic, he began to present purple colored hardened to become ulcerated area in December 2015. Which is why go to the doctor who said soft tissue sonography (01/27/2016) ulcer reporting 29 mm associated with post-infectious cellulitis to drug administration right hemi hip and a left organized hematoma (0.25 cc); culture (01.27.2016) is perform reporting presence of Acinetobacter baumani sensitive Ciprofloxacin treatment indicated Complex currently observed clinical improvement of the injury.