# Shewanella algae as a Rare Cause of Bullous Cellulitis and Sepsis: The First Reported Case in Lithuania

## TL;DR

This paper reports the first case in Lithuania of a severe infection caused by Shewanella algae, leading to leg amputation in an immunocompromised patient.

## Contribution

The study presents the first documented case of Shewanella algae-induced bullous cellulitis and sepsis in Lithuania.

## Key findings

- A 74-year-old woman with diabetes developed severe infection from Shewanella algae after seawater exposure.
- The infection progressed to necrotizing soft-tissue infection requiring multiple amputations.
- No prior cases of S. algae infection in Lithuania were found through an extensive literature review.

## Abstract

Shewanella algae is an emerging marine bacterium capable of causing serious infections in immunocompromised individuals. We report the first documented case in Lithuania of bullous cellulitis caused by S. algae, complicated by necrotizing soft-tissue infection and ultimately requiring leg amputation. To determine whether similar cases had been described earlier in Lithuania, a structured literature review was conducted. We searched PubMed/MEDLINE, Embase, Scopus, Web of Science, and Google Scholar by combining the terms “Shewanella algae,” “Shewanella,” “Baltic Sea,” “wound infection,” “necrotizing infection,” “sepsis,” “case report,” and “Lithuania.” No date limits were set, and all titles and abstracts were screened.

A 74-year-old woman with poorly controlled type 2 diabetes and recent seawater exposure presented with acute right leg pain and skin lesions. Blood and wound cultures confirmed S. algae infection. Despite broad-spectrum antibiotics and intensive care, the patient’s condition deteriorated, requiring below-knee and later above-knee amputation. This case emphasizes the aggressive clinical course S. algae can take in vulnerable patients and highlights the importance of early recognition and multidisciplinary management of severe skin and soft tissue infections.