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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 Apr 19. 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 2021 Feb 10. Epub 2021 Feb 10.

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

J Pediatr Hematol Oncol 2021 Feb 3. Epub 2021 Feb 3.

Departments of Pediatrics, Division of Pediatric Allergy and Immunology Medical Biology Pediatrics, Division of Pediatric Hematology-Oncology & Pediatric HSCT Unit, Faculty of Medicine, Erciyes University Pediatric Allergy and Immunology Clinic, Kayseri City Hospital, Health Science University Betül-Ziya Eren Genome and Stem Cell Center (GENKOK), Kayseri Adana Genetic Diseases Diagnosis and Treatment Center (AGENTEM) Department of Medical Genetics, Faculty of Medicine, Cukurova University, Adana, Turkey Department of Pediatrics, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.

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 Apr;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

BMJ Case Rep 2021 Jan 19;14(1). Epub 2021 Jan 19.

Division of Infectious Diseases, Mayo Clinic, Phoenix, Arizona, USA

Herein, we report a case of a 68-year-old woman receiving ibrutinib for chronic lymphocytic leukaemia, who presented with septic shock and a progressive necrotic lesion on her nose. Surgical pathology of the nasal lesion revealed evidence of tissue necrosis, and both tissue and blood culture grew A diagnosis of ecthyma gangrenosum was made. Additional investigations also led to the discovery of invasive pulmonary aspergillosis. Read More

Ann Dermatol Venereol 2021 Mar 16;148(1):63-65. Epub 2021 Jan 16.

Service de Dermatologie, HIA Sainte-Anne, Toulon, France. Electronic address:

Enferm Infecc Microbiol Clin (Engl Ed) 2021 Jan 10. Epub 2021 Jan 10.

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

Pediatr Dermatol 2021 Mar 2;38(2):458-460. Epub 2021 Jan 2.

Division of Dermatology, Children's National Hospital, Washington, DC, USA.

Ecthyma gangrenosum is a rare cutaneous infection that occurs classically in immunocompromised patients with Pseudomonas aeruginosa bacteremia and is associated with a high mortality rate. Causative pathogens may exhibit various antibiotic evasion mechanisms, and thus, treatment may be challenging. We present a case of ecthyma gangrenosum in association with an implantable port in which cultures confirmed ten unique strains of Pseudomonas aeruginosa, highlighting the ability of this pathogen to form biofilms, rapidly mutate and ultimately evade antibiotic therapy. Read More

IDCases 2021 20;23:e01026. Epub 2020 Dec 20.

Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University and King Saud University Medical City, Saudi Arabia.

Ecthyma gangrenosum (EG) is a well-recognized dermatological condition classically associated with infection, however, the association with other bacteria, especially gram positive, is rare. There are only a few reported cases of EG caused by staphylococcal infection. Here, we report a case in a young patient with chronic kidney disease (CKD) presenting with EG secondary to Methicillin Resistant . Read More

BMC Pediatr 2020 12 1;20(1):540. Epub 2020 Dec 1.

Intensive Care Unit, Key Medical Laboratory of Pediatrics, Key Laboratory of Child Development and Disorders, Chongqing Health Bureau, Ministry of Education, Children's Hospital of Chongqing Medical University, 136#, Zhong Shan 2nd Rord, Yuzhong District, Chongqing, People's Republic of China.

Background: X-linked agammaglobulinemia (XLA, OMIM#300,300), caused by mutations in the Bruton tyrosine kinase (BTK) gene, is a rare monogenic inheritable immunodeficiency disorder. Ecthyma gangrenosum is a cutaneous lesion caused by Pseudomonas aeruginosa that typically occurs in patients with XLA and other immunodeficiencies.

Case Presentation: We report the case of a 20-month-old boy who presented with fever, vomiting, diarrhea, and ecthyma gangrenosum. Read More

Int J Hematol 2021 Jan 24;113(1):3-4. Epub 2020 Nov 24.

Center for Postgraduate Education and Training, National Center for Child Health and Development (NCCHD), Tokyo, Japan.

Actas Dermosifiliogr (Engl Ed) 2021 Jan 9;112(1):1-13. Epub 2020 Oct 9.

Servicio de Anatomía Patológica, Hospital Universitario de Cruces, Barakaldo, Vizcaya, España.

Vascular occlusion has multiple, diverse clinical manifestations, some of which can have grave consequences for patients. The causes of vascular occlusion are also highly variable, ranging from thrombi triggered by the uncontrolled activation of coagulation mechanisms, on the one hand, to endothelial dysfunction or occlusion by material extrinsic to the coagulation system on the other. In a 2-part review, we look at the main causes of vascular occlusion and the key clinical and histopathologic findings. Read More

Ann Hematol 2020 Oct 7. Epub 2020 Oct 7.

Department of Radiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.

An Bras Dermatol 2020 Sep - Oct;95(5):668-669. Epub 2020 Jul 15.

Department of Dermatology, Faculty of Medicine, University of Chile, Santiago, Chile.

An Bras Dermatol 2020 Jul - Aug;95(4):407-417. Epub 2020 May 16.

Faculdade de Medicina, Universidade Estadual Paulista, Botucatu, SP, Brazil. Electronic address:

The severe bacterial diseases discussed herein are those that present dermatological lesions as their initial manifestations, for which the dermatologist is often called upon to give an opinion or is even the first to examine the patient. This review focuses on those that evolve with skin necrosis during their natural history, that is, necrotizing fasciitis, Fournier gangrene, and ecthyma gangrenosum. Notice that the more descriptive terminology was adopted; each disease was individualized, rather than being referred by the generic term "necrotizing soft tissue infections". Read More

Int J Infect Dis 2020 08 1;97:19-20. Epub 2020 Jun 1.

Service de médecine intensive et reanimation, hôpital Saint-Louis, 1 Avenue Claude Vellefaux, 75010, Paris, France.

Transpl Infect Dis 2020 Aug 26;22(4):e13319. Epub 2020 May 26.

Division of Infectious Diseases, Department of Internal Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA.

Ecthyma gangrenosum is a cutaneous manifestation of severe systemic pseudomonas infection and is commonly associated with bacteremia. It is common in immunocompromised patients with underlying neutropenia or leukopenia. We report a patient with heart transplant who developed a single lesion of ecthyma gangrenosum in the absence of bacteremia with a review of reported cases in solid organ transplant patients. Read More

Orbit 2021 Apr 30;40(2):172. Epub 2020 Apr 30.

Department of Dermatology, Austin Regional Clinic , Austin, TX, USA.

J Microbiol Immunol Infect 2020 Dec 17;53(6):1030-1034. Epub 2020 Apr 17.

Department of Pediatrics, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address:

X-linked agammaglobulinemia (XLA) is a primary immunodeficiency disease. We reported two 7-month-old identical male twins with Pseudomonas aeruginosa sepsis who initially manifested as oral ecthyma gangrenosum and were finally diagnosed to have XLA. In both cases, we confirmed the c. Read More

J Clin Rheumatol 2020 Feb 19. Epub 2020 Feb 19.

From the University of Florida Health, Jacksonville, FL.

Curr Opin Infect Dis 2020 04;33(2):101-109

Division of Infectious Diseases, Department of Health Sciences DISSAL, University of Genoa.

Purpose Of Review: Skin and soft tissue infections (SSTIs) in patients with hematological malignancies are frequent, but dedicated epidemiological studies are limited. The aim of this review is to provide updated description of the main etiological agents, differential diagnosis, and treatment.

Recent Findings: In addition to common causes of bacterial skin infections in any kind of patients, such as streptococci and staphylococci (the letter frequently resistant to methicillin), Pseudomonas aeruginosa is a frequent agent in patients with hematological malignancies, with high virulence and typical infection presenting as ecthyma gangrenosum. Read More

Clin Dermatol 2019 Sep - Oct;37(5):528-547. Epub 2019 Jul 17.

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA. Electronic address:

The color purple can be seen in several types of eruptions including inflammatory dermatoses like lichen planus, infectious dermatoses like ecthyma gangrenosum, neoplasms like Kaposi sarcoma, and vasculitis and vasculopathy. The current review focuses on the clinical appearance, pathophysiology, and treatment of several vasculitides and vasculopathies including capillaritis, cutaneous small-vessel vasculitis, immunoglobulin A (IgA) vasculitis, cryoglobulinemia, granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis, microscopic polyangiitis, polyarteritis nodosum, warfarin-induced skin necrosis, heparin-induced thrombocytopenia, purpura fulminans, antiphospholipid antibody syndrome, calciphylaxis, levamisole-induced vasculopathy, and thrombotic thrombocytopenic purpura. Dermatologists play a central role in treating patients with cutaneous vasculitis and vasculopathy and may have the opportunity to facilitate identification of systemic disease by diagnosing cutaneous vasculitis and vasculopathy. Read More

Cureus 2019 Aug 31;11(8):e5543. Epub 2019 Aug 31.

Neurological Surgery, Mayo Clinic, Rochester, USA.

Ecthyma gangrenosum is a rare physical exam finding pathognomonic for severe bacteremia and typically associated with pseudomonal sepsis. The characteristic skin lesions appear as ring-shaped hemorrhagic pustules that evolve into necrotic ulcers. In the present case, a 62-year-old woman with a pulmonary adenocarcinoma treated with surgical resection and adjuvant chemotherapy developed three symptomatic brain masses. Read More