Escherichia coli chest-wall hemorrhagic cellulitis associated with central-line placement

Cellulitis is a common clinical entity. Hemorrhagic cellulitis is distinctly unusual and is most frequent in compromised hosts. In normal or near normal hosts, hemorrhagic cellulitis may rarely complicate gram-negative sepsis. Usually, hemorrhagic cellulitis occurs below the waist. The differential diagnosis includes invasive streptococcal infection, mixed aerobic and anaerobic infection, gram-negative sepsis, and gross gangrene. We present the first-known case of Escherichia coli chest-wall hemorrhagic cellulitis associated with a central line in a patient with renal failure. (Heart Lung® 2000;29:450-2.)