Blistering Distal Dactylitis Caused by Acinetobacter lwoffii in an Immunocompetent Patient: A Case Report

Background and Clinical Significance: Blistering distal dactylitis is a localized infection of the distal phalanx, most commonly affecting children and adolescents and typically caused by group A β-hemolytic Streptococcus. Infections due to atypical organisms are rare. Involvement of atypical organisms such as Acinetobacter lwoffii is extremely rare; Case Presentation: We report an 18-month-old boy presenting with hemorrhagic crustation over bilateral big toes for 2 weeks; wound culture swab revealed Acinetobacter lwoffii. Patient was managed with 5 mL of trimethoprim–sulfamethoxazole twice daily for a week; Conclusions: This case highlights the rare involvement of Acinetobacter lwoffii in blistering distal dactylitis and emphasizes the importance of culture-guided diagnosis and treatment.