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Bacterial, Mycobacterial, and Spirochetal (Nonvenereal) Infections
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Overview: Impetigo is a highly contagious superficial bacterial skin infection commonly found in children (Figure 6.2). It is typically caused by staphylococcal organisms and less commonly by streptococcal bacteria. Ecthyma is a deeper form of impetigo that can lead to crusted sores and ulcers (Figure 6.3). This is usually caused by Streptococcus pyogenes and Staphylococcus aureus.
Acute erythematous rash on the trunk and limbs
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
Pathogenic Staphylococcus aureus can cause a variety of skin infections depending on the depth of inoculation (Fig. 7.30). An infection just under the stratum corneum causes impetigo (seeFig. 4.20, p. 77). Vesicles rapidly break to form erosions with golden crusts on the surface. In the newborn, you may see intact blisters with pus in them (bullous impetigo, seeFig. 4.21, p. 77). Ecthyma is an infection of the full thickness of the epidermis. Folliculitis is a superficial infection of the hair follicle with a pustule at the opening of the follicle. Deeper infection results in either a boil if the whole follicle is involved or a carbuncle if multiple adjacent follicles are involved.
Skin infections
Published in Ronald Marks, Richard Motley, Common Skin Diseases, 2019
In tropical and subtropical areas, an impetigo-like disorder is spread by flies and biting arthropods. This disorder is more destructive than ordinary impetigo and produces deeper, oozing and crusted sores and is caused mostly by beta-haemolytic streptococci. It is sometimes known as ecthyma. There have been several outbreaks of acute glomerulonephritis following episodes of this infective disorder.
A Belgian student with black eschars
Published in Acta Clinica Belgica, 2023
Astrid Van Reempts, Liesbet De Meester, Koen Blot, Ann-Sophie Candaele, Hilde Beele, Jo Van Dorpe, Diana Huis in ‘t Veld
Given the initial differential diagnosis of ecthyma caused by Staphylococcus aureus (with no improvement after a few days of amoxicillin clavulanic acid and azithromycin before admission), she was based on the antibiogram of a wound culture treated with a combination of doxycycline (100 mg two times daily for four days) and levofloxacin, temporarily associated to doxycycline due to unfavorable clinical evolution; the topical treatment consisted of antiseptic wound dressings. Later on, the antibiotics were changed to clindamycin monotherapy because of a newly developed maculopapular skin eruption. We presume this rash was a paraviral eruption or a hypersensitivity reaction to one of the previous antibiotics. The diffuse maculopapular erythema spontaneously disappeared after a few days. The regional lymphadenopathy decreased slowly over several weeks. One scalp ulceration required superficial debridement and a course of amoxicillin/clavulanic acid for five days due to secondary bacterial infection and delayed wound healing. Magnetic resonance imaging (MRI) of the skull showed no signs of osteomyelitis. After six months, all lesions were completely healed with limited atrophic scarring. The clinical course of the cowpox lesions on the chin and scalp is shown in Figure 2.
Ecthyma gangrenosum associated with Proteus bacteremia
Published in Baylor University Medical Center Proceedings, 2018
Andrew Hawrylak, Susan Seago, Edana Stroberg, Richmond Hunt, Megan Greene Newman
Ecthyma gangrenosum is a dermatologic finding classically associated with Pseudomonas aeruginosa bacteremia in immunocompromised patients.1–3 Patients develop this rare finding when organisms colonize the media and adventitia of arteries or veins, leading to local necrosis and ulceration of the epidermis and dermis.4 Although most reports involve coinfection with Pseudomonas, ecthyma gangrenosum has been associated with other bacterial organisms such as Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, fungal organisms including Candida and Aspergillus, and viral infection with herpes simplex virus.5 Though cases describing Proteus vulgaris causing ecthyma gangrenosum exist, this is believed to be the first case of ecthyma gangrenosum caused by Proteus mirabilis.6 The presence of polymicrobial lesions without bacteremia has been previously described, highlighting the importance of broad-spectrum antibiotic therapy when the diagnosis is suspected until definitive body tissue cultures may be obtained by punch biopsy.7 In this case, initial lack of adequate empiric antibiotic coverage for Enterococcus potentially contributed to this patient’s poor outcome.
Ecthyma gangrenosum of the eyelid in an immunocompromised patient
Published in Orbit, 2021
Natalie A. Homer, Aliza Epstein, Paul M. Hoesly
Ecthyma gangrenosum is a rare complication of pseudomonas bacteremia, primarily affecting immunocompromised patients, but may also be found in children and immunocompetent adults. Lesions may affect the face in 6% of cases, and initially appear as painless red macules and progress to induration, bullae and eventual gangrenous ulceration. Herein we report the fifth case to affect the periorbital area. Management includes surgical debridement and escharotomy, followed by systemic antibiotic therapy. The wound may be allowed to heal by granulation or be managed with delayed reconstruction following bacterial eradication. Ecthyma gangrenosum should be considered in cases of periorbital necrosis, particularly in immunocompromised patients and those with pseudomonal sepsis.