Ecthyma gangrenosum in a kidney transplant recipient with pseudomonas septicemia

Collini, Francis J.; Spees, Everett K.; Munster, Andrew M.; Dufresne, Craig R.; Millán, Juan C.

doi:10.1016/0002-9343(86)90834-x

Cited by 15 publications

(2 citation statements)

References 15 publications

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“…Skin infections are described less frequently. Until now, the literature was dominated by descriptions of ecthyma gangrenosum in both immunocompromised [14][15][16][17] and immunocompetent 18,19 individuals. Moreover, cases of necrotizing fasciitis caused by P. aeruginosa were reported.…”

Section: Main Findings Of the Studymentioning

confidence: 99%

Microbiological contamination of cosmetic products – observations from Europe, 2005–2018

Michałek

John

Santos

2019

Acad Dermatol Venereol

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Background Although cosmetic products are not expected to be fully aseptic, their potential microbiological contamination might be dangerous, especially for immunocompromised patients. The extent of such contamination of cosmetics in Europe is poorly studied. Objectives The objective of this study was to explore whether microbiologically contaminated cosmetic products are available for sale in Europe and what type of contamination was reported. Methods We searched the European Union Rapid Information System for dangerous non‐food products (Rapex), a database of non‐compliant products among 31 European countries, to identify microbiologically contaminated cosmetics reported between 2005 and 2018, and present a detailed summary of these notifications. Results In the years 2005–2018, 104 reports on microbiologically contaminated cosmetics were identified. Twenty of them were products for children. The majority of the products (65.38%) were produced in Rapex member states. In most cases, contamination was caused by Gram‐negative bacteria (59.62%), mostly Pseudomonas spp. (35.58%) and Enterobacter spp. (11.54%). Conclusions Gram‐negative rod‐shaped bacteria are the most common microbiota contaminating cosmetic products in Europe. Most of the reported microbiologically contaminated cosmetics originated from European countries.

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Section: Main Findings Of the Studymentioning

confidence: 99%

Microbiological contamination of cosmetic products – observations from Europe, 2005–2018

Michałek

John

Santos

2019

Acad Dermatol Venereol

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“…The lesions occur mainly in the perineal region (57%), but may also arise on the extremities (30%), trunk (6%) and face (6%) 2 . Typically, EG occurs in immunosuppressed patients with leukemia 3 or AIDS, 4,5 in organ transplant recipients, 6,7 and in patients with agammagloblinemia, 8 hypogammaglobulinemia 9 and diabetes, 10 and the lesions are frequently associated with poor prognosis and high mortality. However, EG lesions sometimes occur in healthy people 11,12 and cases without septicemia due to P. aeruginosa are also occasionally found 3,13 .…”

Section: Introductionmentioning

confidence: 99%

Ecthyma gangrenosum without pseudomonas septicemia in a kidney transplant recipient

Nakai

Takenaka

Kishimoto

2008

The Journal of Dermatology

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We report a case of ecthyma gangrenosum (EG) without septicemia in a renal transplant recipient who presented with a 1-month history of painful ulcers, vesicles and bullae on the face and extremities. Histopathological findings revealed subepidermal bullae covered by a necrotic epidermis containing an infiltrate of a moderate number of lymphocytes, neutrophils and necrotic collagen. Many dilated and congested capillaries were also present due to thrombi beneath the bullae, with alteration of collagen fibers through the superficial to middle dermis with some infiltrate. A culture from the ulcers revealed the presence of Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus, whereas the results of repeated blood cultures were negative. The ulcers were completely cured by early appropriate i.v. antibiotic therapy with granulocyte colony-stimulating factor, without progression to EG with septicemia. An immunocompromised state due to immunosuppressive drugs, in addition to diabetes mellitus, hypogammaglobulinemia and hypoproteinemia, may have caused the EG and herpes zoster may have exacerbated the condition.

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Facial Ulcerations in an Immunocompromised Patient

Blumenthal

Sood

Aronson³

et al. 1990

Arch Dermatol

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A 49-year-old woman with metastatic colon and primary infiltrating ductal breast carcinoma presented with a 10-day history of multiple facial ulcerations after having received two courses of chemotherapy with cisplatin and fluorouracil and 30 Gy of total brain irradiation. These lesions initially appeared 3 days following her second course of chemotherapy as erythematous plaques that developed bullae and subsequently opened and drained. When the patient presented to her physician 1 week prior to admission, she was afebrile and had mucositis, the facial lesions mentioned above, and a white blood cell count of 0.9 X 109/L. She was treated with nystatin for her mucositis and cefadroxil for her facial ulcerations. She also continued to receive dexamethasone for cerebral edema secondary to brain metastases. Over the next week, her facial lesions continued to enlarge, and she developed a new bulla on her abdomen.On admission to the hospital, the patient was afebrile and had stable vital signs. Examination of her skin revealed five deeply ulcerating tumors on her right cheek, right and left chin, right forehead, and right medial canthus. They had erythematous rolled borders and a black central eschar (Fig 1). She also had a 3-cm nodule with white central necrotic tissue and bullae on her left lower abdomen (Fig 2).Laboratory studies included a complete blood cell count, which revealed a white blood cell count of 26X10VL, with a differential cell count of 0.42 segmented neutrophils, 0.21 lymphocytes, 0.19 band cell forms, 0.07 metamyelocytes, 0.06 myelocytes, and 0.04 promyelocytes. A skin biopsy specimen was taken from one of these ulcérations (Fig 3).

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Ecthyma gangrenosum in a kidney transplant recipient with pseudomonas septicemia

Cited by 15 publications

References 15 publications

Microbiological contamination of cosmetic products – observations from Europe, 2005–2018

Microbiological contamination of cosmetic products – observations from Europe, 2005–2018

Ecthyma gangrenosum without pseudomonas septicemia in a kidney transplant recipient

Facial Ulcerations in an Immunocompromised Patient

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