EIKENELLA-CORRODENS INFECTIONS - CASE-REPORT IN 2 ADOLESCENT FEMALES WITH IDDM

OBJECTIVE - To alert physicians caring for patients with diabetes to t he microorganism Eikenella corrodens and to discuss the appropriate pr eventive and therapeutic measures to take against this potentially mor bid opportunistic Gram-negative bacilli. CASES - We present two cases of extra-oral E. corrodens infections in adolescent females with IDDM. The first patient had diabetes of 4 years' duration, which was modera tely well controlled. Chronic finger biting resulted in a complex felo n that evolved gradually and worsened while the patient received cepha lexin orally. Delay in seeking further intervention resulted in necros is of her distal fingertip and nail bed. The second patient had poorly controlled diabetes for 5 years. She developed an acute thigh abscess at an insulin injection site that resolved after drainage and intrave nous antibiotics. CONCLUSIONS - E. corrodens commonly inhabits the hum an oral cavity and becomes a pathogen mostly when host defenses are im paired, causing abscesses and infections that are at times fatal. Pati ents with IDDM are compromised hosts and with daily microtrauma to the ir skin via glucose monitoring and insulin injections, are prone to de velop E. corrodens infections that can be introduced through oral secr etions by licking or biting their skin. Educational efforts aimed at p reventing exposure of traumatized skin to oral secretions can minimize the risk of E. corrodens infections in compromised hosts. Early intra venous administration of antibiotics, bearing in mind E. corrodens res istance to clindamycin, metronidazole, and other antibiotics, coupled with prompt surgical intervention, is essential in successfully managi ng E. corrodens infections.