title: Spontaneous gram-negative cellulitis in a liver transplant recipient.
abstract: A 47-year-old liver transplant recipient developed fever and cellulitis on the 8th post-transplant day. The clinical appearances were of a rapidly advancing cellulitis. The patient had a past history of severe peripheral edema and hypoalbuminemia. Blood cultures and skin biopsy grew Escherichia coli. To our knowledge, this is the first reported case of E. coli cellulitis in a liver transplant recipient. However, cases have previously been described in patients with cirrhosis or idiopathic nephritic syndrome, conditions which share predisposing features of peripheral edema and hypoalbuminemia. Bacteremic gram-negative cellulitis should be considered in compromised patients with unusual presentations of cellulitis.
authors.affiliation: UPMC Division of Infectious Diseases, Pittsburgh, PA 15213, USA. patersond@msx.dept-med.pitt.edu
authors.forename: D L
authors.initials: DL
authors.lastname: Paterson
authors.forename: S
authors.initials: S
authors.lastname: Gruttadauria
authors.forename: A
authors.initials: A
authors.lastname: Lauro
authors.forename: V
authors.initials: V
authors.lastname: Scott
authors.forename: I R
authors.initials: IR
authors.lastname: Marino
mesh_terms: D001706:Biopsy; D002481:Cellulitis / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007866:Leg / Q000473:pathology*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology; D012867:Skin / Q000473:pathology