ABSTRACT
Hemorrhagic cellulitis consists of an acute onset of extremely painful erythema which affects dependent areas, followed by dermal hemorrhaging and sloughing of the overlying epidermis. Hemorrhagic cellulitis in the initial stage is frequently misdiagnosed as bacterial cellulitis. The disease differs from cellulitis because of it's large area of hemorrhaging, which is an unusual feature in bacterial cellulitis. Failure to recognize and treat the early stage of the disease results in necrosis of the skin and sometimes gangrene down to the deep fascia. Treatment in the early stages consists of corticosteroids in combination with antibiotics. We report a case of hemorrhagic cellulitis in the right lower leg of a 66-year-old male with diabetes mellitus. Begining as a tender erythematous streak, the lesions became hemorrhagic and evolved progressively through the hemorrhagic vesicobullous stage, to necrotic crusts in about 2 weeks. Cultural isolation showed Enterobacter cloacea.