Staphylococcus hominis cellulitis and bacteremia associated with surgical clips

Streptococcus spp. and Staphylococcus aureus are the most common pathogens causing skin and soft tissue infections (SSTI). Guideline-recommended empiric antibiotics targeting these organisms would also treat coagulase negative Staphylococci, which are not typically considered skin and soft tissue pathogens. Coagulase negative Staphylococci are, however, well known for their propensity to cause indolent infections in the setting of prosthetic material. Here, we present a case of a patient with surgical clips from a femoral artery surgical repair one year prior, presenting with cellulitis at the prior surgical site, complicated by high-grade Staphylococcus hominis bacteremia. Signs of infection persisted after 4 days of appropriate antibiotic therapy and resolved rapidly upon non-steroidal anti-inflammatory administration. This case highlights the importance of recognizing coagulase negative Staphylococci as a possible etiology of cellulitis in patients with prosthetic material, and of considering anti-inflammatory medications as a supplement to antibiotic therapy to hasten resolution of cellulitis in appropriate patients.