Background: Ecthyma gangrenosum (EG) is an infrequent and
discernible cutaneous disease caused by Pseudomonas aeruginosa. In
situations where it is associated with septicemia in debilitated patients, the
prognosis is usually unfavorable.Objective: In this case, we aim to verify risk factors,
clinical,
bacteriological and therapeutic characteristics of ecthyma gangrenosum and we review the literature to highlight the features
of this rare condition and discuss the role of early diagnosis and
treatment.Case Report: We describe the clinical case of a 4-year-old male with bone marrow aplasiawho was presented with characteristic skin lesions
of EG and developed sepsis later.Conclusion: EG is a cutaneous disease characterized by its
aggressive nature. The presence of delayed diagnosis and therapy, along with
sepsis, is closely linked to a high mortality rate. Treatment is empirically
founded on an aggressive initial approach.
References
[1]
Woo-Hyung, C., Yong Kyu, K. and Lee-Sun, K. (1996) Ecthyma Gangrenosum Associated with Aplastic Anemia. Journal of Korean Medical Science, 11, 64-67.
https://doi.org/10.3346/jkms.1996.11.1.64
[2]
El Baze, P., Thyss, A., Caldani, C., et al. (1985) Pseudomonas aeruginosa 0-1 1 Folliculitis: Development into Ecthyma Gangrenosum in Immunosuppressed Patients. Archives of Dermatology, 121, 873-876.
https://doi.org/10.1001/archderm.1985.01660070063016
[3]
Mandel, I.N., Feiner, H.D., Price, N.M., et al. (1977) Pseudomonas epacia Endocarditis and Ecthyma Gangrenosum. Archives of Dermatology, 113, 199-202.
https://doi.org/10.1001/archderm.1977.01640020071013
[4]
Victoria, B., Rares Mircea, B. and Marius, B. (2019) A Case Report of Double Etiology of Ecthyma Gangrenosum. Medicine, 98, e15651.
https://doi.org/10.1097/MD.0000000000015651
[5]
Tomoaki, I., Yoshihiko, S., Maki, T. and Natsuko, D. (2005) Ecthyma Gangrenosum-Like Lesions in a Healthy Child after Infection Treated with Antibiotics. Pediatric Dermatology, 22, 453-456. https://doi.org/10.1111/j.1525-1470.2005.00116.x
[6]
Federico Maria, G., Alessio, B. and Domenico, V. (2014) Ecthyma Gangrenosum in a Newborn Causing External Otitis with Complete Facial Nerve Palsy. Journal of Cutaneous Medicine and Surgery, 18, 210-213.
https://doi.org/10.2310/7750.2013.13067
[7]
Fink, M., Conrad, D., Matthews, M. and Browning, J.C. (2012) Primary Ecthyma Gangrenosum as a Presenting Sign of Leukemia in a Child. Dermatology Online Journal, 18. https://doi.org/10.5070/D34TM8Z0GG
[8]
Zhang, X.T., Jin, W.W., Ma, X.H., Yu, H.F. and Tang, X.H. (2017) Ecthyma Gangrenosum in a 3-Month-Old, Previously Healthy Infant: A Case Report. Medicine, 96, e6244.
[9]
Martínez-Longoria, C.A., Rosales-Solis, G.M., Ocampo-Garza, J. and Guerrero-González, G.A. (2017) Ecthyma Gangrenosum: A Report of Eight Cases. Anais Brasileiros de Dermatologia, 92, 698-700. https://doi.org/10.1590/abd1806-4841.20175580
