When Normal Flora Turns Pathogenic: A Pediatric Case of Infectious Eczematoid Dermatitis

TL;DR

A 12-year-old child developed a rare skin infection that responded to targeted antibiotic and anti-inflammatory treatment after initial misdiagnosis.

Contribution

This case report emphasizes the importance of recognizing infectious eczematoid dermatitis in pediatric patients with persistent skin symptoms.

Findings

Staphylococcus epidermidis was identified as the causative organism through skin culture.

Treatment with ciprofloxacin and mometasone furoate 0.1% cream led to clinical improvement.

The patient was lost to follow-up after initial response to treatment.

Abstract

Infectious eczematoid dermatitis (IED) is a rare and often underrecognized inflammatory skin condition, particularly in pediatric patients. We present the case of a previously healthy 12-year-old Hispanic child with erythematous, scaly, and pruritic plaques involving the tragus, antitragus, external auditory meatus and lobule of both ears. The lesions were initially treated with topical fluocinolone acetonide prescribed by an otolaryngologist, without clinical improvement. Upon evaluation in our dermatology clinic, a skin culture revealed Staphylococcus epidermidis as the causative organism. The patient was treated with ciprofloxacin, selected based on antibiotic sensitivity, along with mometasone furoate 0.1% cream to address both infectious and inflammatory components. On follow-up, the lesions showed improvement; however, the patient was later lost to follow-up. This case highlights the need to consider IED in children with refractory eczematous eruptions.

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