Skin and subcutaneous involvement is distinctly unusual when the infecting organism is Streptococcus pneumoniae. Cellulitis associated with bacteremia due to S pneumoniae has been reported in adults with drug addiction1 and macroglobulinemia2 and in children with facial cellulitis.3 From both blood and subcutaneous aspirate cultures, Fleisher et al4 isolated S pneumoniae from one of 25 children who were seen in their emergency department with cellulitis. I am aware of only one previously reported case of a subcutaneous abscess caused by this organism. In that patient, an adult who had had a splenectomy for idiopathic thrombocytopenic purpura 14 months before, blood cultures were negative but a fluctuant mass on the shoulder disclosed S pneumoniae on smear and culture.5 I report two cases of pneumococcal subcutaneous abscess in otherwise healthy children and suggest that their infections occurred as an unusual complication of occult pneumococcal bacteremia.
LISTON TE. Pneumococcal Subcutaneous Abscess in Immunocompetent Children. Am J Dis Child. 1982;136(10):947-948. doi:10.1001/archpedi.1982.03970460077019