AUTHOR=Zhang Liangliang , Dai Yalan , Lin Mengting , Xu Qiuyun , Lin Tingting , Gong Ting , Cheng Bo , Ji Chao , Cai Donghua 

TITLE=Case Report: An Ulceration With a Stalactite Appearance on the Index Finger

JOURNAL=Frontiers in Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.801086

DOI=10.3389/fmed.2022.801086

ISSN=2296-858X

ABSTRACT=Proteus mirabilis, the most widespread species of all the Proteus spp. bacteria, is proven to be one of the most universal pathogens in chronic wounds. In this case, a woman in her 40s consulted a physician about an asymptomatic ulceration with stalactite appearance on the distal of the index finger after she was exposed to needle when vaccinating chickens. The patient did not response to ceftazidime. Physical examination revealed a well-demarcated violescent ulceration with stalactite appearance at the distal end of the index finger. A biopsy of the lesion showed a dense infiltration of multinucleated giant cells, histiocytes and lymphocytes in the dermis. The result of metagenomics next generation sequencing (NGS) showed 306 unique sequence reads of Proteus mirabilis, covering 33.49% of the nucleotide sequences. The pathogen was identified as Proteus mirabilis, which was resistant to ceftazidime. The patient was treated with ciprofloxacin hydrochloride and improved considerably. This case reported a distinctive cutaneous lesion of Proteus mirabilis on human infection and also showed the successful use of NGS in Proteus mirabilis.