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Escherichia coli chest-wall hemorrhagic cellulitis associated with central-line placement

E A Hansen1, B A Cunha

  • 1Infectious Disease Division, Winthrop-University Hospital, Mineola, New York 11501, USA.

Heart & Lung : the Journal of Critical Care
|November 18, 2000
PubMed

Insights

Hemorrhagic cellulitis is rare, especially in the chest wall. This case highlights a unique instance of Escherichia coli-induced chest wall infection in a patient with kidney failure and a central line.

Area of Science:

  • Infectious Diseases
  • Bacteriology
  • Clinical Medicine

Background:

  • Cellulitis is a common bacterial skin infection.
  • Hemorrhagic cellulitis is an unusual presentation, typically seen in immunocompromised individuals.
  • Gram-negative sepsis can rarely cause hemorrhagic cellulitis, usually affecting the lower extremities.

Observation:

  • A patient with renal failure and a central venous catheter developed an unusual form of cellulitis.
  • The infection presented as hemorrhagic cellulitis of the chest wall.
  • Escherichia coli was identified as the causative pathogen.

Findings:

  • This is the first reported case of Escherichia coli chest-wall hemorrhagic cellulitis.
  • The central line was a potential source of infection in this patient with compromised immunity due to renal failure.
  • The presentation deviated from the typical location (below the waist) and pathogen profile for hemorrhagic cellulitis.

Implications:

  • This case expands the known clinical spectrum of hemorrhagic cellulitis.
  • It underscores the importance of considering unusual presentations of gram-negative infections in patients with central lines and renal failure.
  • Early recognition and appropriate antibiotic therapy are crucial for managing such rare but potentially severe infections.

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