Psychosocial impact of recurrent afebrile cellulitis and antibiotic toxicity in an elderly patient

Resumen

Recurrent hospitalizations in elderly patients not only increase morbidity but also have profound psychosocial and behavioral health implications. The complexity of care, polypharmacy, and caregiver burden contribute to poor outcomes and reduced quality of life. Objective. To explore the behavioral and psychosocial challenges associated with recurrent cellulitis and antibiotic toxicity in an elderly woman, highlighting the role of caregiver stress and healthcare system barriers. Method. We present the case of an 87-year-old Puerto Rican woman with multiple comorbiditieswho was hospitalized four times in six months for recurrent cellulitis. Clinical data and caregiver narrative were analyzed to assess both medical and behavioral health dimensions. Results. Despite multiple hospitalizations, the patient remained afebrile and presented with atypical signs of infection. Repeated courses of antibiotics, including prolonged linezolid, culminated in lactic acidosis. Her son reported increasing emotional distress, exhaustion, and frustration with fragmented healthcare coordination. The recurrent admissions, lack of continuity, and progressive frailty created psychological strain for both patient and caregiver. The patient died shortly after her last discharge, intensifying the emotional burden on her family. Conclusions. This case illustrates how recurrent infections in the elderly extend beyond biomedical complications to include significant behavioral health consequences. Caregiver stress, treatment fatigue, and systemic barriers are critical determinants of outcomes. Integratingbehavioral health support and care coordination into infection management may improve quality of life for patients and families.