[Recurrent infectious and metastatic cellulitis cause by Escherichia coli].
BACKGROUND
We report a case of recurrent and metastatic infectious cellulitis caused by Escherichi coli.


METHODS
A 79-year-old man with a history of alcoholic cirrhosis and a myelodyplasia syndrome was hospitalized for skin rash and inflammatory edema of the right leg associated with bullous and necrotic lesions. Culture of a bulla puncture fluid grew E. coli. A two-drug intravenous antibiotic regimen and surgical cleansing led to a favorable outcome in 3 weeks. One week after withdrawal of the antibiotics, the patient developed a recurrent erythematous and inflammatory lesion of the right flank. Blood culture grew E. coli. The intravenous antibiotics were reinitiated immediately and provided rapid regression of the skin signs. Search for a urinary or digestive tract neoplastic focus was negative.


CONCLUSIONS
E. coli cellulitis is a very uncommon usually fatal condition. Clinicians should be aware of a possible association with alcoholic cirrhosis. In case of recurrence, it is important to search for a digestive, hepatobiliary or urinary tract focus. Broad spectrum empirical antibiotic therapy must be initiated rapidly. Surgery is required in case of necrotizing cellulitis whatever the infectious agent.
Olivier
V
V
Service de Dermatologie, Hôpital de l'Archet, Nice.
Desruelles
F
F
Cua
E
E
Bernard
E
E
Roger
P M
PM
Del Giudice
P
P
Lacour
J P
JP
Dellamonica
P
P
Ortonne
J P
JP
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002481:Cellulitis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology* / Q000601:surgery; D004927:Escherichia coli Infections / Q000150:complications / Q000209:etiology*; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D012008:Recurrence; D012307:Risk Factors
D000900:Anti-Bacterial Agents