Ecthyma gangrenosum
Ecthyma gangrenosum | |
---|---|
Specialty | Infectious diseases |
Ecthyma gangrenosum is a type of skin lesion characterized by vesicles or
This type of skin lesion was first described in association with Pseudomonas aeruginosa by L. Barker in 1897.[3] It was given the name "ecthyma gangrenosum" by Hitschmann and Kreibich.[4]
It mostly occurs in patients with underlying immunocompromise (e.g. malignancy or HIV). Although most cases are due to Pseudomonas aeruginosa infection, there are recent reports of this skin lesion in association with other microorganisms, such as Escherichia coli, Citrobacter freundii, Klebsiella pneumoniae, various other Pseudomonas species, and Morganella morganii.[3]
Signs and symptoms
The primary skin lesion usually starts with a
The lesions may be single or multiple. They are most commonly seen in perineum and under arm pit. However, they can occur in any part of the body.[4]
Mechanism
The organism enters directly through the breakdown of mechanical defense barriers such as
Diagnosis
Diagnosis is made by clinical observation and the following tests.[citation needed]
(1) Gram stain of the fluid from pustules or bullae, and tissue swab.
(2) Blood culture
(3) Urine culture
(4) Skin biopsy
(5) Tissue culture
Magnetic resonance imaging can be done in case of ecthyma gangrenosum of plantar foot to differentiate from necrotizing fasciitis.[4]
Prevention
The main organism associated with ecthyma gangrenosum is Pseudomonas aeruginosa. However, multi-bacterial cases are reported as well. Prevention measures include practicing proper hygiene, educating the immunocompromised patients for awareness to avoid possible conditions and seek timely medical treatment.[4]
Treatments
Treatments involve antibiotics that cover for Pseudomonas aeruginosa.
Surgery will be needed if there is extensive necrosis not responding to medical treatments.[citation needed]
Recent research
A recent retrospective study of all cases of ecthyma gangrenosum from 2004 to 2010 in a university hospital in Mexico shows that neutropenia in immunocompromised patients is the most common risk factor for ecthyma gangrenosum.[5]
References
External links
Classification | |
---|---|
External resources |