Secondary Bacterial Infection Following Insect Bite in Young Adult Male

Case at a Glance

A 24-year-old obese male presented with a one-week history of vesicular lesions and an infected wound that began as an insect bite, requiring antibiotic treatment while traveling abroad.

Patient's Story

The patient, a 24-year-old American male (height 6'1", weight 330 lbs, BMI 43.5), presented to a medical facility in Dubai while on vacation. He reported that approximately one week prior, he sustained what he initially believed to be a mosquito bite. Over the subsequent days, the bite progressed to an open sore, and he began developing small fluid-filled vesicles on surrounding skin areas. The patient expressed significant anxiety about the progression of his symptoms and sought medical attention due to concerns about infection.

Initial Assessment

Physical examination revealed an open, infected wound at the site of the original insect bite, accompanied by multiple small vesicular lesions in the surrounding area. The patient's obesity (BMI 43.5) was noted as a potential complicating factor. Clinical presentation was consistent with secondary bacterial infection of an insect bite with possible impetigo or cellulitis.

The Diagnostic Journey

The attending physician in Dubai evaluated the lesions and determined that the original insect bite had become secondarily infected. The presence of vesicular lesions suggested possible bacterial superinfection with features consistent with impetigo. The patient's travel history and environmental exposure in a different climate were considered as contributing factors.

Final Diagnosis

Secondary bacterial infection of insect bite with associated vesicular lesions, likely impetigo with early cellulitis

Treatment Plan

The patient was prescribed a combination therapy consisting of: 1) Augmentin (amoxicillin-clavulanate) for systemic antibiotic coverage, and 2) Fucidin (fusidic acid) topical ointment for local antimicrobial treatment. Patient education was provided regarding proper wound care and hygiene measures.

Outcome and Follow-up

Patient was advised to continue prescribed medications and monitor for improvement. Instructions were given to seek immediate medical attention if symptoms worsened or if systemic signs of infection developed. Follow-up care arrangements were discussed for continued monitoring during his stay abroad.