Ecthyma Gangrenosum-like Lesions in a Febrile Neutropenic Patient with Simultaneous Pseudomonas Sepsis and Disseminated Fusariosis

Uludokumacı, Seven; Balkan, İ̇lker İnanç; Mete, Bilgül; Özaras, Reşat; Saltoğlu, Neşe; Soysal, Teoman

doi:10.4274/tjh.2012.0030

Cited by 9 publications

(11 citation statements)

References 10 publications

(12 reference statements)

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“…The infection is not necessarily a monoculture and, for example, Fusarium spp. can coexist with P. aeruginosa in the same patient [16].…”

Section: Etiologymentioning

confidence: 99%

“…Any age can be affected, starting from a case of neonatal P. aeruginosa sepsis [33]. In older patients (72 years), Pseudomonas bacteremia can coexist with disseminated fusariosis in wounds [16]. Up to the 1980s, it was generally accepted that EG complicating Pseudomonas bacteremia/sepsis is fatal to most patients, especially infants [3,34].…”

Section: Eg With and Without Septicemiamentioning

confidence: 99%

“…At present, the knowledge about EG is still incomplete. In the emerging literature, authors have tried to overcome this confusion, suggesting two definitions: EG and EG-like lesions [12,16,17] or "mimicking ecthyma gangrenosum" lesions [18]. The current review analyzes the above-described controversies.…”

Section: Introductionmentioning

confidence: 99%

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Ecthyma gangrenosum and ecthyma-like lesions: review article

Vaiman

Lazarovitch

Heller

et al. 2014

Eur J Clin Microbiol Infect Dis

175

192

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The generally accepted definition of ecthyma gangrenosum (EG) states that this condition is pathognomonic of Pseudomonas septicemia (Pseudomonas aeruginosa) and that it should usually be seen in immunocompromised patients, particularly those with underlying malignant disease. The cases described in the literature present a somewhat different picture. Our objective was to analyze this controversy. The review analyzes 167 cases of EG that were described in the literature from 1975 to 2014. All articles on EG cases with EG-specific tissue defect that had signs of general and/or local infection and skin necrosis were included and analyzed, whatever the etiology detected. Necrotic lesions of the skin diagnosed as EG have various microbiological etiology, can occur in immunocompetent or even healthy persons, and are not necessarily connected with septicemia. In published cases, P. aeruginosa was detected in 123 cases (73.65%); of them, there were only 72 cases (58.5%) with sepsis. Other bacterial etiology was detected in 29 cases (17.35%) and fungi were detected in 15 cases (9%). While the clinical picture of the disease and the treatment strategy remain the same, there is no need to invent two separate definitions for Pseudomonas and non-Pseudomonas cases. We suggest accepting a broader definition of EG.

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“…The infection is not necessarily a monoculture and, for example, Fusarium spp. can coexist with P. aeruginosa in the same patient [16].…”

Section: Etiologymentioning

confidence: 99%

Section: Eg With and Without Septicemiamentioning

confidence: 99%

See 1 more Smart Citation

Ecthyma gangrenosum and ecthyma-like lesions: review article

Vaiman

Lazarovitch

Heller

et al. 2014

Eur J Clin Microbiol Infect Dis

175

192

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“…Biopsy and tissue culture are important to make early diagnosis. Although the optimal duration of the antibiotic therapy for EG is still unknown, majority of the cases were treated for at least 2‐3 weeks . It is unclear how the treatment outcome will be affected by the timing of surgical interventions because of the small numbers of case described.…”

Section: Discussionmentioning

confidence: 99%

Ecthyma gangrenosum in a 3‐year‐old boy post‐heart transplantation

Fukui

Shoji

Nagai

et al. 2019

Transplant Infectious Dis

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Abbreviations: ED, emergency department; EG, ecthyma gangrenosum; HSCT, hematopoietic stem cell transplant; P aeruginosa, Pseudomonas aeruginosa; PTLD, post-transplant lymphoproliferative disorder. AbstractEcthyma gangrenosum (EG) is a serious bacterial infection in immunocompromised patients. EG in transplant recipients is rarely reported and may go unrecognized, which may delay initiation of appropriate treatment. We report a case of EG in a pediatric heart transplant recipient who was treated successfully with antibiotics and surgical debridement. K E Y W O R D S ecthyma gangrenosum, heart transplant recipient, Pseudomonas aeruginosa, rituximab

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“…Ecthyma gangrenosum like lesions have been known to be caused by other bacteria including Escherichia coli [3], Klebsiella pneumoniae [4] and Pseudomonas stutzeri [5]. The fungi known to cause these characteristic lesions include Candida [6], Fusarium [7], Mucor [8], Scytalidium [9] and Metarhizium [10].…”

Section: Discussionmentioning

confidence: 99%