Ecthyma gangrenosum-Source Reduction along with Empirical Antibiotics and Wound Care Helps to Treat Serious Infections

Abstract

Ecthyma gangrenosum (Eg) is a cutaneous necrotic lesion that is mostly seen in immunocompromised patients. It reflects a severe sepsis, possibly caused by Pseudomonas aeruginosa, an aerobic Gram-negative opportunistic pathogen that has a high risk of associated mortality in cases where the infection is systemic. These skin lesions may be seen on admission or can develop later. The recognition of Eg lesions permits the earliest possible introduction of the most effective antimicrobial therapy, which is a key prognostic factor for survival. A 52-year-old male patient admitted to the surgery department presented a sepsis associated green color pus discharge with pain and swelling. An empiric antibiotic therapy was prescribed. Five days after admission, pus culture was positive for Pseudomonas aeruginosa. As a result, the decision was made to continue the antibiotic therapy. Empiric therapy leads to granulation tissue formation. Eg can be treated with simple antibiotic therapy.

Keywords: Ecthyma gangrenosum; pseudomonas aeruginosa; sepsis