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SAGE Open Med Case Rep 2022 25;10:2050313X221102113. Epub 2022 May 25.

Department of Clinical Haematology, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan.

Pseudomonal ecthyma gangrenosum is a well-known condition in immunosuppressed patients. However, ecthyma gangrenosum associated with is a rare entity that requires early recognition and optimal antibiotic and surgical management. We herein report the first case of colistin & carbapenem-resistant ecthyma gangrenosum in an acute myeloid leukemia patient. Read More

An Bras Dermatol 2022 May 30. Epub 2022 May 30.

Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

Rev Med Interne 2022 May 24. Epub 2022 May 24.

Service de médecine interne, Centre Hospitalier Intercommunal Elbeuf Louviers Val de Reuil, Saint Aubin Lès Elbeuf, France.

Germs 2022 Mar 31;12(1):118-123. Epub 2022 Mar 31.

MD, Microbiologist, Department of Microbiology, Faculty of Medicine, Pelita Harapan University, Banten, 15811, Indonesia.

Introduction: Ecthyma gangrenosum (EG) is a rare cutaneous manifestation commonly associated with infection in immunocompromised individuals. Additionally, different bacterial and fungal pathogens have also been identified. However, co-infection on EG lesions has never been reported before. Read More

J Dermatol 2022 Apr 19. Epub 2022 Apr 19.

Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.

Pediatr Neonatol 2022 Mar 26. Epub 2022 Mar 26.

Department of Paediatrics, Women and Children Hospital Kuala Lumpur, 50586 Jalan Pahang, Kuala Lumpur, Malaysia.

CMAJ 2022 03;194(12):E461

Department of Medicine, Oregon Health & Science University, Portland, Ore.

Eur J Clin Microbiol Infect Dis 2022 May 23;41(5):779-786. Epub 2022 Mar 23.

Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain.

Cutaneous manifestations developed in the course of sepsis are poorly documented in the medical literature beyond those related to specific pathogens or classical clinical pictures such as purpura fulminans or ecthyma gangrenosum. The objective of this study was to determine the overall prevalence of sepsis-related skin findings and evaluate their possible impact on the prognosis of septic patients. Single-centre, retrospective study of septic patients with documented bloodstream infections admitted in a tertiary hospital during 2019. Read More

BMJ Case Rep 2022 03 22;15(3). Epub 2022 Mar 22.

Infectious Diseases and Immunodeficiency Unit, Pediatrics Department, Hospital de Santa Maria, Lisboa, Portugal.

Cureus 2022 Jan 14;14(1):e21225. Epub 2022 Jan 14.

Department of Pulmonology, Laiko General Hospital, Athens, GRC.

Ecthyma gangrenosum (EG) is an uncommon necrotizing vasculitis that affects mainly immunocompromised and burn patients, and it is frequently associated with bacteremia. However, cases of EG with other related pathogens and cases of EG affecting immunocompetent hosts have also been described in the literature. Besides, less common cases of EG without bacteremia have been reported. Read More

Am J Dermatopathol 2022 Apr;44(4):279-281

Department of Dermatology, University of Nebraska Medical Center, Omaha, NE.

Abstract: In this brief report, we describe a 16-year-old patient with pre-B-cell acute lymphoblastic leukemia on chemotherapy who presented to the emergency department with a fever and "bruise-like" area on his left forearm. Empiric antibiotic therapy was initiated, and initial tissue biopsy demonstrated findings consistent with ecthyma gangrenosum. On day 4 of admission, initial blood cultures grew Moraxella nonliquefaciens, and targeted antibiotic therapy was initiated and continued for a total of 21 days. Read More

JAC Antimicrob Resist 2021 Dec 11;3(4):dlab188. Epub 2021 Dec 11.

Department of Infectious Diseases, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy.

Objectives: To describe our real-life experience with cefiderocol in XDR and difficult-to-treat resistant (DTR-P) infections without any other available treatment options.

Methods: We included patients with a proven infection due to an XDR/DTR-P, who had failed on previous regimens, and were treated with cefiderocol, following them prospectively to day 90 or until hospital discharge or death.

Results: Seventeen patients treated for >72 h with cefiderocol were included: 14 receiving combination regimens (82. Read More

IDCases 2021 7;26:e01304. Epub 2021 Oct 7.

Department of Infectious Diseases, Communicable Diseases Centre, Hamad Medical Corporation, Doha, Qatar.

Ecthyma gangrenosum is a cutaneous infection typically associated with Pseudomonas aeruginosa. However, it is rarely caused by Stenotrophomonas maltophilia which might be overlooked leading to devastating consequences. We describe this case to avoid delays in the diagnosis and treatment of this aggressive infection, especially in immunocompromised patients. Read More

Pediatr Infect Dis J 2022 03;41(3):238-242

Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata, Policlinico "G.B: Rossi", Verona, Italy.

Background: To depict ecthyma gangrenosum (EG) clinical presentation and evolution in a large multicenter pediatric retrospective collection of children with malignancies or bone marrow failure syndromes, to facilitate early diagnosis.

Methods: EG episodes diagnosed in the period 2009-2019 were identified by a retrospective review of clinical charts at centers belonging to the Italian Pediatric Hematology Oncology Association.

Results: Thirty-eight cases of EG occurring in children (male/female 16/22; median age 5. Read More

Postepy Dermatol Alergol 2021 Aug 17;38(4):537-543. Epub 2021 Sep 17.

Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland.

In most cases is a consequence of bloodstream infection in immunodeficient patients. This bacterium is characterized by multi-drug resistance and has a number of mechanisms that allow it to survive even in extreme conditions. The disease is characterized by an aggressive course involving the skin and mucous membranes, leading to ulceration with signs of necrosis within 12 to 24 h. Read More

J Am Coll Emerg Physicians Open 2021 Oct 17;2(5):e12553. Epub 2021 Sep 17.

UC College of Medicine, Department of Pediatrics Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA.

X-linked agammaglobulinemia (XLA) is a primary immunodeficiency caused by mutations in the gene for Bruton's tyrosine kinase , with affected males most commonly presenting with recurrent bacterial infections during the first few years of life. Here we present a 17-month-old male with a chief complaint of worsening rash and fever, whose history of streptococcal pneumonia meningitis at 5 months of age prompted suspicion for an underlying immunodeficiency and subsequent diagnosis of XLA. Bacterial meningitis is a rare initial presentation of XLA, and therefore physicians may easily overlook any underlying immunodeficiency. Read More

Enferm Infecc Microbiol Clin (Engl Ed) 2021 12 23;39(10):526-527. Epub 2021 Sep 23.

Servicio de Anatomía Patológica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.

Clin Case Rep 2021 Aug 16;9(8):e04259. Epub 2021 Aug 16.

Internal Medicine Department Centro Hospitalar Vila Nova de Gaia/Espinho Vila Nova de Gaia Portugal.

Cutaneous findings should be actively sought in suspected cases of sepsis, as some of them (such as ecthyma gangrenosum) may provide clues about the infectious agent involved and the patient's immunosuppression status. Read More

J Pediatr 2021 Dec 13;239:241-242. Epub 2021 Aug 13.

Division of Pediatric Critical Care Medicine, Okinawa Prefectural Nanbu Medical Center & Children's Medical Center, Okinawa, Japan.

Cureus 2021 May 10;13(5):e14941. Epub 2021 May 10.

Internal Medicine, Moffitt Cancer Center, Tampa, USA.

In this article, we review a case of necrotizing cellulitis and myositis in a neutropenic leukemic patient. He underwent a series of investigations to reach the diagnosis of pyoderma gangrenosum (PG). The lesion improved dramatically after pertinent identification and initiation of appropriate treatment. Read More

Medicine (Baltimore) 2021 May;100(18):e25867

Department of Emergency Medicine, St. Mary's Hospital, Kurume, Japan.

Rationale: Ecthyma gangrenosum (EG) is an uncommon cutaneous infection usually associated with Pseudomonas aeruginosa bacteremia in immunocompromised patients, particularly those with underlying malignant diseases. Despite its rarity, especially in immunocompetent or nondiagnosed immunodeficiency patients, EG can present as the first manifestation of an underlying immunosuppression.

Patient Concerns: A 42-year-old Japanese man was admitted to our hospital with a 3-day history of a painless red macule on his right forearm and fever. Read More

J Pediatr Intensive Care 2021 Jun 8;10(2):148-151. Epub 2020 May 8.

Division of Pediatric Immunology Diseases, Dr. Sami Ulus Maternity and Children's Training and Research Hospital, Ankara, Turkey.

septicemia is rare in previously healthy children. Skin lesions such as subcutaneous nodules and ecthyma gangrenosum may be the first manifestation of infection that have rarely been reported. Herein we reported a previously healthy 6-month-old boy patient who presented with suppurative otitis media, multiple nodules, septic shock, and was identified in cultures of the blood, skin lesions, and purulent material of his ears. Read More

Intern Med 2021 Oct 19;60(19):3187. Epub 2021 Apr 19.

Department of Infectious Disease Medicine, Osaka City General Hospital, Japan.

BMC Infect Dis 2021 Apr 12;21(1):344. Epub 2021 Apr 12.

German Center for Infection Research (DZIF), partner site Munich, Munich, Germany.

Background: Ecthyma gangrenosum (EG) is a cutaneous infectious disease characterized by eschar-like skin ulcers typically caused by Pseudomonas aeruginosa. Here, we report a case of relapsing EG in a patient who had returned from a trip to Colombia, thus establishing EG as an important differential diagnosis of tropical diseases, and demonstrating that even long-term antibiotic treatment can result in only partial remission of EG.

Case Presentation: A 77-year-old man with underlying chronic lymphocytic leukemia (CLL) on ibrutinib treatment was admitted because of a superinfected mosquito bite on the left ear and multiple partially necrotic skin lesions disseminated all over the entire body five days after returning from a trip to Colombia. Read More

Clin Case Rep 2021 Mar 1;9(3):1787-1788. Epub 2021 Jan 1.

Division of General Internal Medicine Tokai University School of Medicine Isehara Japan.

This report has strong implications for carefully examining the common skin signs of cancer patients receiving chemotherapy. These signs can warn clinicians of the potential for severe infections such as fatal sepsis. Read More

Neurologia (Engl Ed) 2021 Mar 13. Epub 2021 Mar 13.

Servicio de Medicina Interna Hospital Universitario La Paz, Spain.

Late-onset neutropaenia is defined as an absolute neutrophil count of <1.5×10cells/μL starting>4 weeks after the last dose of rituximab, in the absence of other identifiable causes. Late-onset neutropaenia is a rare adverse reaction to rituximab (observed in approximately 5% of patients). Read More

Arch Dis Child Fetal Neonatal Ed 2022 05 10;107(3):261. Epub 2021 Feb 10.

Princess Amalia Department of Pediatrics, Department of Neonatology, Isala Zwolle, Zwolle, The Netherlands

J Pediatr Hematol Oncol 2022 01;44(1):e62-e67

Departments of Pediatrics, Division of Pediatric Allergy and Immunology.

Severe congenital neutropenia (SCN) is a rare disease. Autosomal recessive forms of SCN are more frequent in countries where consanguineous marriages are common. In this report, we describe a 54-day-old female with neutropenia who presented with ecthyma gangrenosum. Read More

Postgrad Med J 2021 Feb 5. Epub 2021 Feb 5.

Internal and Hospital Medicine, Moffitt Cancer Center, Tampa, Florida, USA

Curr Opin Infect Dis 2021 04;34(2):72-79

Third Department of Internal Medicine, Sotiria General Hospital, School of Medicine, National and Kapodistrian University, Athens, Greece.

Purpose Of Review: Pseudomonas aeruginosa is an opportunistic pathogen with considerable morbidity and mortality, particularly in vulnerable hosts. Skin manifestations are common, either representing local inoculation or secondary skin seeding following bloodstream infections. As patients with various predisposing conditions are expanding, we sought to review the most recent published evidence regarding epidemiology, risk factors and diagnosis of skin manifestations of P. Read More