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Cellulitis due to Myroides odoratimimus in a patient with alcoholic cirrhosis

2007; Oxford University Press; Linguagem: Inglês

10.1111/j.1365-2230.2007.02590.x

1365-2230

C Bachmeyer, H. Entressengle, Kiarash Khosrotehrani, Gideon Goldman, F. Delisle, Guillaume Arlet, Gilles Grateau,

Infectious Disease Case Reports and Treatments

Conflict of interest: none declared. A 49‐year‐old homeless man with a history of chronic alcohol misuse was admitted to the hospital for cellulitis of the right leg. His temperature was 39 °C. His right calf and thigh were red, oedematous and painful. Several traumatic erosions were present on the legs. No lymph nodes were palpable. Massive ascites was found, with collateral venous circulation. Laboratory tests found macrocytic anaemia (8.9 g/day) with slight leucocytosis (10.2 × 109/L; normal < 10.0) with raised neutrophil level (8.2 × 109/L; normal < 7.5). C reactive protein was 79 mg/L (normal < 10). He was hypoalbuminaemic (9.2 g/L; normal > 38) with polyclonal hypergammaglobulinaemia. Abdominal ultrasonography showed a homogeneous hepatomegaly, splenomegaly and ascites. Ascites puncture found protein level to be 7 g/L with 30 red cells/mm3 and 50 white cells/mm3 (neutrophils 12%, lymphocytes 12% and other cells 76%) and cultures were negative. Upper endoscopy showed oesophagitis and typical features of portal hypertension.