Ecthyma gangrenosum without bacteremia. Report of six cases and review of the literature

Locoregional Multiple Nodular Panniculitis Induced byPseudomonas aeruginosaWithout Septicemia

“…6 It remains unclear whether this patient had pseudomonal abscesses rather than panniculitis. The anatomoclinical features of our cases distinguished them from ecthyma gangrenosum, another secondary cutaneous manifestation of P aeruginosa that has also been described with no septicemia, 8 including in immunocompetent patients. 9 There has been some controversy whether ecthyma gangrenosum without bacteremia represents a manifestation of initially undetectable bacteremia or a primary cutaneous infection.…”

Ecythema gangrenosum in a previously healthy child

“…In this type, a few necrotic ulcers occur mostly in the buttocks (6). The mortality rate is 15% in this type of ecthyma gangrenosum which is non-bacteriemic and generally involves negative blood culture (2,10).…”

Pseudomonas aeruginosa septic shock associated with ecthyma gangrenosum in an infant with agammaglobulinemia

“…One major clinical feature in almost all patients is the presence of neutropenia. In two retrospective studies, all the patients with EG were immunocompromised leading to severe neutropenia, and the absolute neutrophil count of less than 500/mm 3 were strongly related to the clinical outcome 4,6,7,11,12 .…”

“…This disease has been related to life-threatening septicemic infections and high mortality 6,7,9 . The most important predisposing factor that can lead to EG is the presence of any kind of immunodeficiency associated with severe neutropenia 1,6,7,14 . One of the major examples of this condition is found in patients with agammaglobulinemia or hypogammaglobulinemia who manifest this association.…”