Treatment and Management of Shewanella algae Necrotizing Cellulitis

Shewanella algae is considered an emerging novel pathogenic cause of severe skin infections. The organism is a gram-negative motile bacillus commonly found in marine environments. While the more common causes of skin and soft tissue infections include Staphylococcus aureus, beta-hemolytic Streptococci, and/or Vibrio vulnificus, S. algae have also been isolated in rare cases. Notably, this organism is more likely to cause infection in patients with open wounds and is commonly seen in patients with underlying diabetes and peripheral vascular disease. In this case, a 71-year-old male patient who developed severe necrotizing cellulitis infection of the left lower limb complicated by bacteremia. The patient was immediately started on empiric treatment with intravenous antibiotics until S. algae was identified; thereafter, the antibiotic treatment was adjusted accordingly. During the course of hospitalization, the patient required serial surgical debridement procedures to achieve source control. The purpose of the case report is to increase awareness among healthcare professionals on how S. algae infections are contracted, the clinical presentation and effects this microbe has on patients with chronic comorbidities, along with the antibiotic treatment, as no guidelines have been established thus far.