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Group B streptococcal cellulitis in an adult
Postgraduate Medicine
|April 1, 1985
Summary
Group B Streptococcus infections are increasingly seen in adults, causing cellulitis and bacteremia. Elderly patients with chronic lymphocytic leukemia presenting with skin infections require prompt diagnosis and treatment.
Area of Science:
- Infectious Diseases
- Dermatology
- Hematology
Background:
- Group B Streptococcus (GBS) is a significant pathogen primarily affecting neonates.
- Adult GBS infections are increasingly recognized, particularly in immunocompromised individuals.
- Chronic lymphocytic leukemia (CLL) is a hematologic malignancy associated with increased infection risk.
Observation:
- A 75-year-old man with stage IV CLL presented with unilateral arm cellulitis and vesicular rash.
- Gram stain revealed gram-positive cocci; blood and wound cultures identified GBS and Staphylococcus aureus.
- The patient received a seven-day course of acyclovir and penicillin G.
Findings:
- The patient was diagnosed with cellulitis and bacteremia caused by GBS and S. aureus.
- Treatment with acyclovir and penicillin G led to resolution of cellulitis and crusting of vesicular lesions within seven days.
- This case highlights GBS as a cause of severe skin and soft tissue infection in an elderly patient with CLL.
Implications:
- Primary care physicians should consider GBS in the differential diagnosis of cellulitis in adult patients, especially the elderly.
- Increased awareness of GBS as an adult pathogen is crucial for timely diagnosis and management.
- This case underscores the importance of microbiological diagnosis in complex skin infections in immunocompromised hosts.