[Non necrotizing bacterial cellulitis and bacteriemia due to Shewanella putrefaciens]

Area of Science:

• Microbiology
• Infectious Diseases
• Dermatology

Background:

• Shewanella putrefaciens is a Gram-negative bacterium known to cause opportunistic infections.
• These infections, including skin, soft tissue, and bloodstream infections, primarily affect immunocompromised patients.
• Bullous pemphigoid is an autoimmune blistering skin disease often treated with immunosuppressants.

Observation:

• An 86-year-old male patient presented with infectious cellulitis of the leg.
• The patient had a history of bullous pemphigoid resistant to corticosteroid therapy.
• The patient was undergoing treatment with mycophenolate mofetil, an immunosuppressive medication.

Findings:

• Shewanella putrefaciens was identified as the causative agent of the patient's leg cellulitis.
• The patient also exhibited Shewanella putrefaciens bacteremia, indicating bloodstream infection.
• The clinical presentation and bacteremia occurred in the context of immunosuppressive therapy for bullous pemphigoid.

Implications:

• This case underscores the potential for Shewanella putrefaciens to cause severe infections in immunocompromised hosts.
• It highlights the importance of considering unusual pathogens in patients with underlying conditions and immunosuppressive treatment.
• Early recognition and appropriate antimicrobial therapy are crucial for managing Shewanella putrefaciens infections and bacteremia.