Ecthyma Gangrenosum in an Immunocompetent Infant - A Case Report

Zhao H, Arodi M, Almaie S, Otabi T, Ahamis N, Haza S and Rowdhan M

Published on: 2023-11-02

Abstract

The Rationale

Ecthyma gangraenosum (EG) is pathognomonic of Pseudomonas infection or septicemia. It is usually seen in immunocompromised patients presented as erythematous necrotizing ulcers in various parts of the body. Its occurrence in otherwise healthy infants is rare.

Patient Concern

We present a case of EG in a 9-month-old otherwise healthy infant presented with an early single lesion in the cheek that later spread to appear in various parts of the body including the abdomen, thighs, hand, and foot. Involving is characterized by pustules that rapidly evolve into hemorrhagic blisters with central necrosis with

Diagnosis

The confirmation of the diagnosis of ecthyma gangrenosum was done after the isolation of Pseudomonas aeruginosa from the blood and wound culture samples. Histopathology study of the debrided specimens also helped to conclude the diagnosis.

Interventions: the patient had 3 weeks of intensive care and multiple surgical interventions for debridement followed by vacuum drainage. Discharged home after 4 weeks with minimal morbidity.

Lessons

The early diagnosis based on the clinical picture and blood culture and the prompt treatment with broad-spectrum empiric antibiotics, and multiple debridement are the key to a good prognosis in patients with ecthyma gangrenosum.