Chromobacterium violaceum cellulitis and sepsis following cutaneous marine trauma

Chromobacterium violaceum is a gram-negative bacillary organism that characteristically produces the purple pigment violacein. Documented as the cause of clinically relevant human infections in only 35 cases in the United States, C violaceum is particularly seen in patients with a history of cutaneous injury or trauma. We report the case of an 18-year-old woman who was struck by a propeller in a boating accident and sustained multiple deep lacerations of her right lower extremity. Shortly after admission to the hospital, the patient became frebrile and developed leukocytosis. Bacterial cultures revealed C violaceum, which demonstrated a characteristic purple pigment production on blood agar. Antimicrobial therapy was initiated, but 2 days after admission, the skin and subcutaneous tissue surrounding the patient's wounds became necrotic, necessitating an above-the-knee amputation of the right lower extremity (transfemoral amputation). The patient's condition improved after continued antimicrobial therapy and she was subsequently discharged in good health. This case represents a successful outcome of a rare but frequently fatal infection due to a morphologically and geographically distinct human pathogen.