Teren Yedikian^1,, Lisa Piñero¹, Erica Rego¹, Radhika Malhotra¹, Juan Bello¹, Ravi Upadhyay¹

Pseudomonas aeruginosa and Pseudomonas fluorescens are gram-negative bacilli that are ubiquitous in the environment and are known to cause folliculitis, pneumonia, and otitis externa typically in immunocompromised patients. Pseudomonas spp. are rarely associated with cellulitis. We present a case of a 47-year-old woman who presented to the emergency room with left lower leg edema and erythema after being exposed to the multi-purpose cleaning product, Fabuloso®. Recently, a recall regarding multiple lots of this cleaner was made as some of the products have been found to grow both Pseudomonas aeruginosa and Pseudomonas fluorescens. Physical exam revealed a warm, erythematous, and lower left leg lesion that was tender to touch. A computerized tomography of the lower left leg indicated a soft tissue infection with no abscesses or collections. Antibiotics were administered to cover against bacterial causes of nonpurulent cellulitis. The lesion continued to spread, and only began to decrease in size when antimicrobial coverage was broadened to target Pseudomonas spp. This case demonstrates the importance of detailed history taking including environmental exposures as well as rapid recognition of antimicrobial failure.

cellulitis, Pseudomonas aeruginosa, Pseudomonas fluorescens, Fabuloso®