A 68-year-old woman with hepatitis B virus-related cirrhosis (Child–Pugh score of B9 and Model for End-Stage Liver Disease score of 19) was admitted for ascitic decompensation. On day 5 of hospitalisation, the patient developed abrupt, severe pain and rapidly progressive purple erythema on the back of the left foot, extending to the lower leg within 48 h (figure A).
There was no preceding trauma, injection, or insect bite. The patient remained afebrile and haemodynamically stable throughout.
The Lancet Infectious Diseases published a clinical update in Infectious Disease on 01 Apr 2026.
The item focuses on Bullous haemorrhagic cellulitis caused by Escherichia coli in a patient with cirrhosis.
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