Ecthyma Gangrenosum Caused by <i>Escherichia coli</i> in a Previously Healthy Girl

Korbi, M.; Akkari, H.; Hammedi, Faten; Kadri, Y.; Belhadjali, H.; Mastouri, Maha; Zakhama, Abdelfattah; Jamelledine, Zili

doi:10.1111/pde.12595

Cited by 14 publications

(8 citation statements)

References 5 publications

(10 reference statements)

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“…Ecthyma gangrenosum is mostly seen in patients with severe immunodeficiency, including Agammaglobulinemia, aplastic anemia, hematologic malignancies, especially patients with leukemia after chemotherapy, and also in HIV patients. However, it was also reported in patients without defect in the immune system (2)(3)(4). Ecthyma gangrenosum is usually diagnosed based on the patient's history, underlying diseases, blood culture, and tissue culture.…”

Section: Discussionmentioning

confidence: 99%

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Ecthyma gangrenosum Due to Escherichia coli Bacteremia in a Patient with Acute Myeloid Leukemia: A Case Report and a Literature Review About E. coli-Induced Ecthyma gangrenosum

Salehi

Sharifian

Almasian

et al. 2019

Arch Clin Infect Dis

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Introduction: Ecthyma gangrenosum is a skin lesion presenting invasive infection in the skin, which is commonly caused by Pseudomonas. Pathogenesis is mostly attributed to the microbial invasion in cutaneous tissues caused by the microorganism. One of the important, but rare causes of Ecthyma gangrenosum after Pseudomonas is Escherichia coli. Case Presentation: A 45-year-old woman known as a case with acute myeloid leukemia who went into remission due to chemotherapy. After chemotherapy, she was febrile and septic. A physical examination revealed an erythematous round lesion (3 × 3 cm) that had developed on the posterior aspect of the right thigh with central bolus necrosis. E. coli was detected based on both blood cultures. Conclusions: Ecthyma gangrenosum is mostly seen in patients with severe immunodeficiency such as aplastic anemia, hematologic malignancies, especially patients with leukemia after chemotherapy and also in HIV patients. So far, in 11 patients reported in the literature, at least 8 cases are reported lesions on the lower limb, which is the most probable anatomic area for E. coli-induced Ecthyma gangrenosum. The E. coli-induced Ecthyma gangrenosum is a rare infectious lesion that is particularly seen in patients with a malignancy history, and lower extremity lesions should be considered.

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Section: Discussionmentioning

confidence: 99%

“…Also, these lesions may rarely present in patients without bacteremia (1,2). They usually show themselves as one or several macular lesions or papules with a red and inflamed area and then change into a hemorrhagic bulla and finally become necrotic (1,3). The first case of Ecthyma gangrenosum was explained in 1987 and first named in 1930.…”

Section: Introductionmentioning

confidence: 99%

Ecthyma gangrenosum Due to Escherichia coli Bacteremia in a Patient with Acute Myeloid Leukemia: A Case Report and a Literature Review About E. coli-Induced Ecthyma gangrenosum

Salehi

Sharifian

Almasian

et al. 2019

Arch Clin Infect Dis

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“…The finding almost exclusively arrises among critically ill patients, and in particular, those who are immunocompromised. Although rare case reports have identified isolated instances of Proteus species, Escherichia coli , and Staphylococcus epidermidis , almost all reported patients with ecthyma gangrenosum and culture data were shown to harbor Pseudomonas aeruginosa, warranting aggressive anti-pseudomonal treatment where the lesions are observed clinically [3-5].…”

Section: Discussionmentioning

confidence: 99%

Ecthyma Gangrenosum Secondary to Pseudomonal Sepsis Complicated by Acute Respiratory Distress Syndrome Following Craniotomy for Resection of a Metastasis

Marcellino¹,

Perry²,

Graffeo³

2019

Cureus

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Ecthyma gangrenosum is a rare physical exam finding pathognomonic for severe bacteremia and typically associated with pseudomonal sepsis. The characteristic skin lesions appear as ring-shaped hemorrhagic pustules that evolve into necrotic ulcers. In the present case, a 62-year-old woman with a pulmonary adenocarcinoma treated with surgical resection and adjuvant chemotherapy developed three symptomatic brain masses. The lesions were presumed metastatic and initially treated with stereotactic radiosurgery; however, follow-up imaging identified treatment failure of a cerebellar lesion, and the patient was subsequently taken to surgery on an elective basis for suboccipital craniotomy and tumor resection. Although her initial postoperative course was unremarkable, on postoperative day two, she experienced a rapidly progressive neurologic and hemodynamic decline. During this period, numerous ring-shaped, necrotic cutaneous lesions rapidly appeared, consistent with ecthyma gangrenosum. In spite of multi-modality critical care treatment and resuscitation, including milrinone, multiple vasopressors, anti-pseudomonal antibiotics, and prone positioning, the patient progressed to cardiorespiratory failure and died.

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“…Previously, EG was considered pathognomonic of Pseudomonas infection, but it has also been reported in other bacterial infections with group A Streptococcus, methicillin-resistant Staphylococcus aureus, Escherichia coli, Aeromonas hydrophila, Serratia marcescens, and even atypical mycobacteria. 4,5 Moreover, fungal infections such as with Fusarium or Candida species have been associated with EG. 6 In classic bacteremic EG, two pathogenetic mechanisms have been proposed.…”

Section: Discussionmentioning

confidence: 99%

Orbital ecthyma gangrenosum in multiple myeloma

Yohannan

Feldman

2019

Baylor University Medical Center Proceedings

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Ecthyma gangrenosum is a rare and highly lethal cutaneous infection classically associated with Pseudomonas aeruginosa bacteremia. We report a 58-year-old man with multiple myeloma receiving chemotherapy who presented with 2 days of painless left periorbital swelling that rapidly progressed to a blackish eschar. His absolute neutrophil count was 0.10/mm 3 ; platelet count, 14,000/mm 3 ; and hemoglobin, 6 g/dL. Computed tomography showed diffuse left periorbital cellulitis. Blood cultures grew pansensitive Pseudomonas aeruginosa, and the patient died from sepsis and multiorgan failure.

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Ecthyma Gangrenosum Caused by Escherichia coli in a Previously Healthy Girl

Cited by 14 publications

References 5 publications

Ecthyma gangrenosum Due to Escherichia coli Bacteremia in a Patient with Acute Myeloid Leukemia: A Case Report and a Literature Review About E. coli-Induced Ecthyma gangrenosum

Ecthyma gangrenosum Due to Escherichia coli Bacteremia in a Patient with Acute Myeloid Leukemia: A Case Report and a Literature Review About E. coli-Induced Ecthyma gangrenosum

Ecthyma Gangrenosum Secondary to Pseudomonal Sepsis Complicated by Acute Respiratory Distress Syndrome Following Craniotomy for Resection of a Metastasis

Orbital ecthyma gangrenosum in multiple myeloma

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