A Case Report of Cellulitis Caused by Leclercia adecarboxylata in a Thai Boy: A Common Infection From a Rare Pathogen

Leclercia adecarboxylata is a gram-negative bacillus that rarely causes infections in children, especially in Thailand. We report a case of a boy with a wound infection and cellulitis after a punctate injury caused by L. adecarboxylata. A previously healthy 12-year-old boy presented with a 2-month history of infected wound and cellulitis on his left sole after a punctate injury in the garden. He experienced recurrent swelling and purulent discharge despite an incision and drainage and a full course of appropriate antibiotics. Plain films of his left foot showed no radiopaque foreign body or evidence of osteomyelitis. L. adecarboxylata was isolated from the wound tissue culture. Incision and drainage followed by a 2-week course of oral amoxicillin/clavulanic acid was prescribed which resulted in a complete resolution of the lesion. This case emphasizes the significance of identifying L. adecarboxylata as a possible cause of soft tissue infections in Thai children, especially those with a history of puncture wounds. Unusual pathogens should be considered when standard treatments fail to eliminate the infection.