Bacillus cereus causing widespread necrotising skin infection in a diabetic person

We report a unique case of B. cereus cutaneous infection causing extensive skin necrosis in a person with type 2 diabetes mellitus. Examination revealed erythema, pitting oedema and right ankle tenderness. Elevated inflammatory markers supported a diagnosis of cellulitis, and intravenous flucloxacillin was initiated as per local hospital guidelines. Clinical response was poor with the development of spreading cellulitis, desquamated blisters and superficial necrosis. In response to swab culture and sensitivity results, vancomycin was commenced resulting in gradual resolution. Cutaneous necrotising B. cereus infection in a diabetic patient is unusual. The only other reported case was of a necrotising fasciitis affecting the arm, resulting in tissue loss. The challenge lies in recognising this atypical pathogen and initiating sensitive antimicrobial therapy which includes vancomycin, ciprofloxacin, doxycycline and novel agents such as linezolid. Copyright © 2015 John Wiley & Sons.
Source: Practical Diabetes - Category: Endocrinology Authors: Tags: Case report Source Type: research