# Gram-Negative Bacteremia With Atypical Neurologic Presentation Following Tattoo Application

## TL;DR

A diabetic woman developed a rare E. coli infection from a tattoo, showing no local symptoms but systemic issues, highlighting the need for awareness of such complications.

## Contribution

Reports a rare case of gram-negative bacteremia from tattooing with atypical neurological presentation.

## Key findings

- E. coli bacteremia occurred without visible infection at the tattoo site.
- Systemic symptoms led to initial suspicion of a neurological event.
- Early treatment with antibiotics resulted in full recovery.

## Abstract

Tattoo-related infections are typically caused by gram-positive bacteria like Staphylococcus aureus and present with localized symptoms. However, this case describes a 48-year-old diabetic woman who developed Escherichia coli bacteremia without any visible signs of infection at the tattoo site. She presented with systemic symptoms including fever, chills, and weakness, initially raising concerns for a neurological event. Laboratory tests confirmed gram-negative bacteremia, and the tattoo was identified as the likely source. The absence of local manifestations and the rare involvement of E. coli highlight the need for clinicians to consider systemic infections as a potential complication of tattooing, especially in high-risk patients. Early recognition and appropriate antibiotic therapy resulted in the patient’s full recovery. This case underscores the importance of infection control during tattooing and vigilance for atypical presentations.