Leclercia adecarboxylata cellulitis in a neutropenic Thai child with acute myeloid leukemia

Leclercia adecarboxylata is a rare opportunistic Gram-negative organism that has increasingly been recognized as a pathogen in immunocompromised patients. In pediatric populations, infections are uncommon and rarely reported, particularly in Thailand.Case presentation: We report a 3-year-old Thai boy with acute myeloid leukemia in the induction phase who presented with febrile neutropenia and right knee cellulitis following minor trauma. Pus culture grew L. adecarboxylata, which was confirmed by MALDI-TOF mass spectrometry, while blood culture remained negative. Despite profound neutropenia, the infection remained localized without bacteremia. The patient was treated with intravenous ceftazidime and amikacin, followed by oral amoxicillin-clavulanic acid, for a total of 14 days, with complete clinical recovery.

This case highlights L. adecarboxylata as a potential pathogen in immunocompromised children with skin and soft tissue infections, particularly following environmental exposure. Clinicians should be aware that L. adecarboxylata may cause clinically significant skin and soft tissue infections and, in high-risk patients, has also been associated with invasive infections, including bacteremia.