Pneumococcus a Rare Cause of Cellulitis

Streptococcus Pneumoniae (S. pneumoniae) is a common cause of community-acquired pneumonia, although its manifestation as a skin infection is a rare phenomenon. Most skin infections are secondary to Staphylococcus aureus or Streptococcus pyogenes, however, cellulitis caused by pneumococci is an infrequent finding. Pneumococcal cellulitis most often occurs due to bacteremia in patients with chronic illnesses such as diabetes, underlying malignancies, immunosuppressed patients, and patients with the history of injection drug abuse. The nature of the infection can be very fatal leading to fasciitis, myonecrosis, septic shock and ultimately death. We present a case of a 61-year-old female who developed painful swelling and redness of the right face along with bilateral leg involvement. In the emergency room, physical examination revealed multiple cervical lymphadenopathies. Further diagnostic investigations disclosed Low-grade B-cell non-Hodgkin lymphoma upon cervical lymph node biopsy. Blood culture grew Streptococcus pneumoniae as a source of cellulitis. This case demonstrates the importance of immune defects and the ensuing development of pneumococcal-induced cellulitis. Physicians should be vigilant while treating Pneumococcal cellulitis as this may be a sign of the serious underlying medical condition.