BMJ Case Reports 2018; doi:10.1136/bcr-2017-222626
  • Unusual presentation of more common disease/injury

An intertidal mollusk found in a boy’s skin abscess

  1. Albert Khait2
  1. 1 Western University of Health Sciences, College of Osteopathic Medicine of the Pacific, Pomona, California, USA
  2. 2 Department of Pediatrics, Loma Linda University, Loma Linda, California, USA
  1. Correspondence to Dr Albert Khait, akhait{at}
  • Accepted 25 January 2018
  • Published 7 February 2018


Skin abscesses are commonly seen by primary care physicians in the outpatient setting. The majority of these soft tissue infections arise from penetration wounds by inanimate objects, but rarely, a living organism may present as a contributing factor. We present a case of an 11-year-old boy with an unusual skin abscess containing a chequered periwinkle marine snail (Littorina scutulata). The unique characteristics of this intertidal mollusk appear to have enabled it to survive in the subcutaneous tissue for a week, despite the hostile environment of a skin abscess. This case emphasises adherence to current professional guidelines that recommend incision and drainage of suspected skin abscesses and encourages clinicians to take a careful history of present illness which may aid in identification of subsequent cases of marine snails, or other living organisms, residing in skin abscesses.


  • Contributors AK: conceptualised the case report after examining the patient detailed in the manuscript; performed the initial literature review, edited and revised each draft of the manuscript, and provided mentorship for SWL (medical student) on procedures of journal submission. SWL: performed a secondary literature review, compiled background information, drafted the initial manuscript and edited subsequent drafts for journal submission. Both authors: approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Competing interests None declared.

  • Patient consent Guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article