Non-Necrotizing Bullous Cellulitis and Bacteremia: A Rare Presentation of the Shewanella Algae Infection

Abstract

A 58-year-old male with severe psoriasis on Risankizumab presented with painful, left leg swelling with erythema and blisters concerning for necrotizing fasciitis. Intraoperative findings showed non-necrotizing bullous cellulitis. The blood and tissue cultures grew Shewanella algae. A handful case of non-necrotizing bullous cellulitis has been reported but this is the first documented case of non-necrotizing bullous cellulitis and bacteremia in PubMed.

Surgical Site Infection by Shewanella algae After Major Surgery in a Patient With Colorectal Cancer: Case Report

“…Investigations were made to exclude nosocomial infection, including colonization screening for the healthcare staff and culture of the sterile solutions used for abdominal wash during surgery, with negative results. Shewanella algae is susceptible to aminoglycosides, carbapenems, erythromycin, and quinolones [ 11 ]. Many Shewanella species are susceptible to narrower spectrum antibiotics such as amoxicillin and third-generation cephalosporins; however, they can show resistance to imipenem by secreting oxacillinases [ 7 ].…”