# A Rare Case of Shewanella putrefaciens Bacteremia Due to Cellulitis in a Patient With Chronic Lymphedema Without Marine Exposure

## TL;DR

An 80-year-old man with chronic lymphedema and no marine exposure developed a rare Shewanella putrefaciens infection leading to septic shock.

## Contribution

Reports a rare case of S. putrefaciens bacteremia without marine exposure, highlighting chronic lymphedema as a potential risk factor.

## Key findings

- S. putrefaciens bacteremia occurred in a patient with chronic lymphedema and no marine exposure.
- Chronic denuded skin from lymphedema may serve as a portal for bacterial entry.
- The patient presented with septic shock due to cellulitis from the infection.

## Abstract

Shewanella putrefaciens (S. putrefaciens) is a Gram-negative anaerobic organism responsible for opportunistic infections in immunocompromised hosts. It can cause a wide range of infections in humans, including skin and soft tissue infections (SSTIs) and bacteremia. Peripheral vascular disease and the presence of chronic bilateral lower extremity ulcers may serve as risk factors for these infections. This is a case report of an 80-year-old male with a history of peripheral vascular disease and chronic lymphedema of the bilateral lower extremities who presented with generalized weakness. He was found to have septic shock and Shewanella putrefaciens bacteremia secondary to left lower extremity cellulitis. There was no history of exposure to the marine environment. However, the patient had multiple comorbid conditions and chronic denuded skin due to lymphedema, which may have provided a nidus for bacterial proliferation and entry into the bloodstream.