22 December 2025
: Case report 
Afebrile Recurrent Cellulitis Complicated by Linezolid-Induced Lactic Acidosis in an Elderly Patient
Unusual or unexpected effect of treatment, Adverse events of drug therapy, Educational Purpose (only if useful for a systematic review or synthesis)
Yanizbeth Yambó-Chévere BCDEF 1*, Rafael Bermúdez-Rivera BE 1,2DOI: 10.12659/AJCR.951194
Am J Case Rep 2025; 26:e951194
Table 1 Summary of hospitalizations, organisms, therapies, and outcomes.
| Hospitalization | Duration of stay | Site(s) of cellulitis | Key labs/ findings | Organisms cultured | Treatment (antibiotics) | Outcome |
|---|---|---|---|---|---|---|
| 1 | 13 days | Right lower limb ulcer + bilateral upper limbs | CRP=9.8 mg/dL, ESR=110 (mm/h) | , | IV cefepime (10 d), oral linezolid (14 d total incl. 7 d after discharge) | Improved; discharged with 7-day oral linezolid |
| 2 | 26 days | Recurrent right lower limb + bilateral upper limbs | CRP=1.89 mg/dL, ESR=119 (mm/h) | Linezolid (10 d IV, 7 d oral), piperacillin-tazobactam (5 d) | Partial response; discharged on linezolid | |
| 3 | 7 days | Right lower limb + bilateral upper limbs | CRP=1.10 mg/dL, ESR=102 (mm/h) | + others | IV cefepime (14 d), linezolid (14 d) | Improved; discharged with home care |
| 4 | 27 days | Right lower limb + bilateral upper limbs | Lactate 2.5–3.1 mmol/L, CRP=11.1 (mg/dL), bacteremia | + | Broad-spectrum antibiotics (meropenem), linezolid discontinued | Discharged clinically fragile; died 2 days later |
| All laboratory values represent peak measurements during each admission. Antibiotic durations are approximate. All episodes were afebrile, with normal WBC counts. ESR – erythrocyte sedimentation rate (mm/h); CRP – C-reactive protein (mg/dL). | ||||||