An Unusual Case of Subcutaneous Arm Abscess Caused by Eikenella corrodens and Streptococcus intermedius

Abstract

We report a case of a unilateral, infected, subcutaneous arm abscess with Eikenella corrodens and Streptococcus intermedius in a 51-year -old female patient with endometrioid adenocarcinoma, who underwent a total abdominal hysterectomy two months ago. She presented with a painful, subcutaneous swelling on the right arm, which was aspirated, and pus was sent for cultures and susceptibility testing. Cultures of the pus yielded growth of E. corrodens and S. intermedius. The patient was treated with amoxicillin-clavulanic acid and had resolution of symptoms. Blood or other site cultures were not sent; hence, the source of origin could not be determined. E. corrodens rarely causes infection beyond the colonized sites and is usually associated with periodontal disease or bite wounds. Nevertheless, in our case, the lesion presented recently and increased in size gradually, over the course of a few weeks and without either periodontal disease or a history of trauma. Based on the disease history and examinations, we identified no clue of the path via which the pathogen formed the subcutaneous abscess in this case. In conclusion, it is unusual to encounter such an abscess caused by E. corrodens without an open wound or an obvious source. Treatment of such an abscess and localized infection depends on the choice of the antibiotic agent along with a surgical approach. To our knowledge, this is the first case of an arm abscess with E. corrodens without an open wound or a prominent portal of entry.

Keywords: Eikenella corrodens, Streptococcus intermedius, Subcutaneous abscess