An unusual case of Escherichia coli cellulitis and bacteremia in an immunocompetent patient


Published: 23 December 2022
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Authors

Cellulitis secondary to Escherichia coli (E. coli) is a rare phenomenon, particularly in an immunocompetent patient. We report an unusual case of an immunocompetent 84-year-old female presenting with E.coli bacteremia and E. coli cellulitis in the right lower leg. We postulate that bacterial translocation from the gastrointestinal tract to the bloodstream is the most likely source of E. coli infection. Whilst a common condition, cellulitis can pose a diagnostic and therapeutic challenge when a causative organism is not identified. Thorough investigation and consideration of atypical organisms such as E.coli are essential to permit targeted antimicrobial therapy and prevent patient deterioration.


1. Sunder S, Haguenoer E, Bouvet D, et al. Life-threatening Escherichia coli cellulitis in patients with haematological malignancies. J Med Microbiol. 2012;61:1324-1327.
2. Kaper JB, Nataro JP, Mobley HLT. Pathogenic Escherichia coli. Nature Reviews Microbiology. 2004;2:123-140.
3. Buchanan R, Stoesser N, Crook D, Bowler IC. Multidrug-resistant Escherichia coli soft tissue infection investigated with bacterial whole genome sequencing. BMJ Case Rep. 2014;2014.
4. Yang S, Jiang WM, Yang HL. ALK-positive anaplastic large cell lymphoma of the thoracic spine occurring in pregnancy: A case report. World J Clin Cases. 2019;7:2857-2863.
5. Raff AB, Kroshinsky D. Cellulitis: A Review. JAMA. 2016;316:325-337.
6. Yoon TY, Jung SK, Chang SH. Cellulitis due to Escherichia coli in three immunocompromised subjects. Br J Dermatol. 1998;139:885-888.
7. Janny S, Bert F, Dondero F, et al. Fatal Escherichia coli skin and soft tissue infections in liver transplant recipients: report of three cases. Transpl Infect Dis. 2013;15:E49-53.
8. Pasini E, Aquilani R, Testa C, et al. Pathogenic Gut Flora in Patients With Chronic Heart Failure. JACC Heart Fail. 2016;4:220-227.
9. Mortimer PS. Cellulitis in chronic oedema. Br J Dermatol. 2021;185:10-11.
10. Chira S, Miller LG. Staphylococcus aureus is the most common identified cause of cellulitis: a systematic review. Epidemiol Infect. 2010;138:313-317.
11. Leppard BJ, Seal DV, Colman G, Hallas G. The value of bacteriology and serology in the diagnosis of cellulitis and erysipelas. Br J Dermatol. 1985;112:559-567.
Nguyen, J. K., Hoxhallari , E., & Daffy, J. (2022). An unusual case of <i>Escherichia coli</i> cellulitis and bacteremia in an immunocompetent patient. Dermatology Reports, 15(2). https://doi.org/10.4081/dr.2023.9603

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