A 54 years old female was admitted to hospital with a diagnosis of cellulitis.She was commenced on Dicloxacillin and subsequently Gentamycin and then Vancomycin when she failed to respond.I saw her for the first time today after she had been seen by an Infectious diseases specialist who queried a deep fungal infection.The calf was swollen and the lesions were tender with a bruised appearance.She was diabetic controlled on diet and oral hypoglycemics.
Culture revealed Staphylococcus aureus and Aeromonas.The latter has been responsible for cellulitis and necrotizing fasciitis.It responds to Bactrim and 3rd generation cephalosporins