Multiple erythematous nodules as a manifestation of Pseudomonas aeruginosa septicemia

Schlossberg, D.

doi:10.1001/archderm.116.4.446

Cited by 14 publications

(15 citation statements)

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“…Cutaneous abscesses due to P. aeruginosa have mainly been observed in immunocompromised patients with septicemia. [1][2][3][4] These severe infections are completely different from the chronic and indolent course observed in our patient who had no systemic symptoms such as fever or bacteremia. It is likely that the portal of entry of the infection was the leg ulcer since P. aeruginosa with the same antibiogram profile was evidenced on the ulcer 3 months earlier.…”

Section: Discussioncontrasting

confidence: 58%

Atypical nodular panniculitis

Picard

Quatrebarbes

Gueït

et al. 2011

International Journal of Infectious Diseases

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Suppurative panniculitis usually occurs among immunocompromised patients and can be caused by opportunistic pathogens or by secondary infectious lesions in the context of septicemia. Herein we report the case of an 82-year-old woman with multiple red nodules on the leg caused by Pseudomonas aeruginosa, not related to a blood disseminated infection. The present case represents an unusual presentation of indolent suppurative panniculitis caused by P. aeruginosa.

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Section: Discussioncontrasting

confidence: 58%

Atypical nodular panniculitis

Picard

Quatrebarbes

Gueït

et al. 2011

International Journal of Infectious Diseases

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“…There have been some reports on the histological findings of cutaneous lesions by punch biopsy in sepsis by P. aeruginosa, but there is no correlation of those with the evolution of sepsis after bacterial challenge or with the survival time. These findings were characterized by a necrotizing and hemorrhagic vasculitis of venules and arterioles without intimal damage [13], occasional thrombosis of dermal vessels, scarce inflammatory infiltrate [14], extravasation of red blood cells [15], and in some cases, mild necrosis of epidermis and moderate infarction of dermis [16]. Although, the histological findings of systemic infection by P. aeruginosa in the present study were similar to those reported by casereports in humans, no study exists on the pathological alterations of the skin of the non-immunocompromised human host with sepsis by multidrug-resistant isolates.…”

Section: Discussionmentioning

confidence: 99%

Skin Biopsy is Predictive of Outcome in Experimental Sepsis by Multidrug-Resistant Pseudomonas aeruginosa

Tziortzioti¹,

Petropoulou²,

Τσαγανός³

et al. 2007

TODJ

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To evaluate whether histological findings of skin in sepsis by Pseudomonas aeruginosa could be a predictive factor of progression to death, histological alterations after challenge by one multidrug-resistant isolate were studied in 24 rabbits. Acute pyelonephritis was induced after ligation of the right ureter and injection of 10 8 CFU per kg of body weight into the renal pelvis. Biopsy samples of skin were taken on necropsy. Mean survival of animals after bacterial challenge was 5.23 days. Main histological findings of skin were inflammation and swelling of dermis; thickening of endothelium; presence of thrombi in vessels; necrobiotic changes of the hair follicles. Serum TNF was negatively correlated to histology of dermis and follicles. Positive correlation was found between survival and swelling of dermis. It is concluded that prolongation of survival was accompanied by intense edema of the dermis. A punch skin biopsy might be a predictive factor of sepsis outcome.

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“…There have been several reports on the histologic findings of cutaneous lesions in sepsis by P. aeruginosa . These findings were characterized by a necrotizing and hemorrhagic vasculitis with accumulation of gram-negative bacilli in the adventitious and medial layers of the deep vessels without affecting the intima [13], extravasation of red blood cells [14]and, in some cases, mild necrosis of epidermis and moderate infarction of dermis [15, 16]. In the present study, the main histologic findings of a systemic infection by P. aeruginosa were similar and included inflammation and swelling of the dermis with perivascular invasion by neutrophils and lymphocytes, thickening of the endothelium and infiltration of the vessel wall by polymorphonuclear leukocytes, extravasation of red blood cells, necrobiotic changes and presence of acantholytic-like cells within the wall of the hair follicles.…”

Section: Discussionmentioning

confidence: 99%

Early Cutaneous Alterations in Experimental Sepsis by <i>Pseudomonas aeruginosa</i>

Petropoulou¹,

Giamarellos‐Bourboulis²,

Kavatzas³

et al. 2004

Dermatology

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Background: To evaluate whether histopathologic findings of skin in sepsis by Pseudomonas aeruginosa correlate with the clinical course. Methods: Histological alterations after bacterial challenge by one susceptible (A) and two multidrug-resistant isolates (B and C) of P. aeruginosa were studied in 18 rabbits. Sepsis was induced by the intravenous infusion of 1 × 10⁸ CFU by a catheter in the right jugular vein; blood was sampled for the estimation of tumor necrosis factor α (TNF-α) and malondialdehyde (MDA). Skin biopsies were collected along with a subcutaneous fat specimen for culture. Results: The mean survival was 0.85, 1.75 and 11.00 days after challenge by isolates A, B and C, respectively. The main histologic findings of skin were: inflammation and swelling of the dermis; thickening of the endothelium and infiltration of vessel wall and lumen by polymorphonuclear leukocytes; extravasation of red blood cells, and necrobiotic changes of the hair follicles. Serum TNF-α was elevated in animals challenged by isolate A compared to challenge by isolates B and C. Concentrations of MDA were similar for all isolates. Mean log₁₀ of viable cells isolated from subcutaneous fat were 5.74, 2.74 and 1.40 after challenge by isolates A, B and C, respectively. Conclusions: Prolongation of survival was accompanied by lower serum TNF-α, decreased viable cells from subcutaneous fat and intensified inflammatory response in the dermis and subcutaneous tissue. These findings might be of importance for immunomodulatory intervention.

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Multiple erythematous nodules as a manifestation of Pseudomonas aeruginosa septicemia

Abstract: In two patients with Pseudomonas septicemia, numerous large, indurated, subcutaneous nodules developed. These lesions, as well as the other cutaneous manifestations present, resolved with antibiotic therapy.

Cited by 14 publications

References 0 publications

Atypical nodular panniculitis

Atypical nodular panniculitis

Skin Biopsy is Predictive of Outcome in Experimental Sepsis by Multidrug-Resistant Pseudomonas aeruginosa

Early Cutaneous Alterations in Experimental Sepsis by <i>Pseudomonas aeruginosa</i>

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