The bacteria stroke: Leclercia adecarboxylata folliculitis in a healthy swimmer—an emerging aquatic pathogen?

A 12-year-old healthy boy presented with a 2-month painful acneiform eruption. On exam erythematous follicular papules and pustules were scattered over bilateral shoulders and back. These surfaces were moderately tender to light palpation; the patient even complained that clothing in contact with his skin elicited pain. Doxycycline 75 mg po qd × 10 days was prescribed to cover common Staphylococcus aureus folliculitis. Due to the atypical presentation of significant pain, a bacterial culture was collected.