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Wound Healing, Ulcers, and Scars
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Saloni Shah, Christian Albornoz, Sherry Yang
Ecthyma gangrenosum is associated with Pseudomonas aeruginosa infection and generally develops in immunocompromised patients. These lesions are rapidly progressive, beginning as small, painless macules and becoming large necrotic ulcers with pustules and surrounding erythema. The most common location is the axillary and anogenital regions.
Unexplained Fever in Infectious Diseases Section 1: Viruses, Chlamydia, Mycoplasma, Rickettsiae, Higher Bacteria, Cell-Wall Deficient Bacteria, And Fungi
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
Finally, skin lesions can help the diagnosis as they are accessible to punction or biopsy. The large macronodular lesions, of 0.5 to 1 cm in diameter, unique or multiple, described in leukemic patients, can be seen in the scalp of heroinomans. Some lesions are clinically identical to ecthyma gangrenosum.133
Invasive Mold Infections
Published in Johan A. Maertens, Kieren A. Marr, Diagnosis of Fungal Infections, 2007
Fernanda P. Silveira, Flavio Queiroz-Telles, Marcio Nucci
The lesions of cutaneous aspergillosis usually begin as macules, papules, nodules, or plaques. In neonates the lesions evolve to pustules and necrotic ulcers (56). Infections occurring in catheter exit sites usually begin with an erythematous lesion and those arising from occlusive dressings may have the appearance of a hemorrhagic bulla (58). Secondary lesions usually occur in the setting of disseminated aspergillosis. They may be single or multiple, papular or nodular, and are well circumscribed. The lesions may be painful and eventually develop central necrosis, taking the appearance of an ecthyma gangrenosum-like lesion.
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.
Orbital ecthyma gangrenosum in multiple myeloma
Published in Baylor University Medical Center Proceedings, 2019
Ecthyma gangrenosum (EG) is a rare skin infection classically associated with Pseudomonas aeruginosa bacteremia and typically seen in critically ill neutropenic patients.1 EG is seen in approximately 2% of cases with P. aeruginosa bacteremia, with no specific gender predilection.2 Most EG lesions involve the anogenital region; facial involvement is rare. We report a case of orbital EG in a 58-year-old man with neutropenia who presented with periorbital swelling.