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The British Journal of Diabetes & Vascular Disease
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Haemorrhagic bullous Streptococcus pneumoniae cellulitis in type 2 diabetes mellitus

Lukman M Hakeem

Infectious Diseases Unit, Victoria Hospital (NHS Fife), Kirkcaldy, Fife, UK, lukman.hakeem{at}faht.scot.nhs.uk

Mahantesh Urolagin

Infectious Diseases Unit, Victoria Hospital (NHS Fife), Kirkcaldy, Fife, UK

Diptendu N Bhattacharyya

Infectious Diseases Unit, Victoria Hospital (NHS Fife), Kirkcaldy, Fife, UK

Ian W Campbell

Diabetes Centre, Victoria Hospital (NHS Fife), Kirkcaldy, Fife, UK

Gareth Griffiths

Vascular Surgical Unit, Ninewells Hospital, Tayside, Dundee, UK

Although Streptococcus pneumoniae is the most common cause of community-acquired bacterial pneumonia, its involvement in skin infection is notably infrequent. Typically, patients with pneumococcal cellulitis have a background of alcohol abuse, diabetes or immunosuppression due to an underlying chronic illness. In contrast to other common bacterial infections patients often require surgical interventions and prolonged hospitalisations due to tissue necrosis, suppurative complications and bacteraemia. Early recognition and aggressive management is vital in reducing morbidity and mortality. We describe a case of a diabetic patient who presented with haemorrhagic bullous pneumococcal cellulitis and required vascular surgical intervention due to peripheral vascular disease and extensive tissue necrosis. Br J Diabetes Vasc Dis 2008;8:75—79

Key Words: Streptococcus pneumoniae • pneumococcus • cellulitis • diabetes mellitus

The British Journal of Diabetes & Vascular Disease, Vol. 9, No. 2, 75-79 (2009)
DOI: 10.1177/1474651408100353


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