Persistent Subcutaneous Abscesses Following Pseudomonas Sepsis

Subcutaneous Nodules with Pseudomas Septicaemia in an Immunocompetent Patient

“…Dermatological manifestations of pseudomonas septicaemia are varied and include vesiculo-bullous lesions 4 , pink maculo-papular plaques on the trunk like the rose spots in typhoid fever 5 , sharply demarcated haemorrhagic cellulitis which may ulcerate 6 , grouped petechiae 7 , ecthyma gangrenosum which is pathognomic of pseudomonas infection 1 and erythematous or violaceous subcutaneous nodules 8 . These disseminated nodules are usually found on the limbs and are usually nonfluctuant and tender 9 . Histologically, there is dense neutrophil infiltration of the subcutaneous fat with subdermal suppurative panniculitis and the presence of viable organisms 7 .…”

“…Histologically, there is dense neutrophil infiltration of the subcutaneous fat with subdermal suppurative panniculitis and the presence of viable organisms 7 . They can harbour these organisms weeks after blood cultures are negative 4,9 and in some cases may require incision and drainage 9 . Urgent biopsy of a lesion for histological and microbiological studies is useful to clarify the infective aetiology and to exclude the presence of vasculitis or other pathology.…”

Panniculitis with pseudomonas septicaemia in AIDS

“…Pseudomonas infections have been associated with erythematous nodules but infrequently [3,5,[7][8][9][10][11][12][13] and this is only the second case to be reported in a patient with AIDS [13]. Pseudomonas septicaemia more commonly presents with ecthyma gangrenosum [1][2][3][4][5][6].…”

“…and metastatic abscesses [3]. Erythematous nodules most likely amounting to panniculitis have been described [3,5,[7][8][9][10][11][12], but only once in AIDS [13].…”

Pseudomonal sepsis with subcutaneous nodules in an HIV-infected individual with high CD4 counts

“…[5][6][7][8][9][10][11][12] Several of these are in the immunocompromised host 5,8,10 though few are in HIV-infected individuals. Sangeorzan et al 11 described two patients, both with low CD4 counts (!200!10 9 /l).…”