[Streptococcus pneumoniae cellulitis in a diabetic patient].

Area of Science:

• Infectious Diseases
• Microbiology
• Clinical Medicine

Background:

• Pneumococcal cellulitis is a rare bacterial infection.
• It commonly affects the head, neck, and trunk in immunocompromised individuals (hematological malignancies, lupus erythematosus).
• Limb cellulitis is more prevalent in patients with diabetes mellitus, drug abuse, or alcoholism, often presenting with septic shock.

Observation:

• A 72-year-old male with a history of alcoholism and diabetes mellitus presented with cellulitis and septic shock.
• Infection was caused by Serotype 19 Streptococcus pneumoniae.
• The isolated S. pneumoniae exhibited reduced susceptibility to penicillin (MIC: 0.75 mg/l).

Findings:

• The patient presented with severe sepsis and septic shock.
• Blood and cellulitis cultures confirmed Streptococcus pneumoniae infection.
• Intravenous antibiotic therapy was initiated, combining ceftriaxone, metronidazole, and ciprofloxacin.

Implications:

• This case underscores the importance of considering pneumococcal cellulitis in patients with risk factors like diabetes and alcoholism.
• Prompt diagnosis and appropriate antibiotic treatment, even for penicillin-non-susceptible strains, can lead to favorable outcomes.
• The study highlights the effectiveness of combination antibiotic therapy in managing severe pneumococcal infections.