Cellulitis Caused by Staphylococcus epidermidis in a Patient With Leukemia

Abstract

The pathogenetic potential of Staphylococcus epidermidis has been traditionally ignored because of its frequent isolation from normal skin and in blood cultures from patients without septicemia. Occasionally found in polymicrobial cutaneous abscesses, 1 this ubiquitous microorganism has recently emerged as a cause of serious infections in immunocompromised hosts. 2-4 When the face is affected, it is vital to recognize the organism's pathogenicity and differentiate it from the bacteria producing other devastating infections. We describe a patient with leukemia in whom an S epidermidis infection produced an extensive facial cellulitis. Report of a Case A 67-year-old woman with acute myelocytic leukemia, in relapse after several courses of chemotherapy, was admitted to the laminar air-flow unit for remission-induction chemotherapy. At that time, her WBC count was 15,000/cu mm, with 40% circulating blasts. The patient received prophylactic treatment with oral antibiotics, including metronidazole, trimethoprim, and ketoconazole. Five days after admission, the patient became