Ecthyma gangrenosum: a report of eight cases

Abstract: Ecthyma gangrenosum is a rare skin infection classically associated with Pseudomonas aeruginosa. We performed a retrospective study of all cases diagnosed with ecthyma gangrenosum from 2004-2010 in a university hospital in Mexico (8 cases, 5 female patients and 3 male patients, ages between 4 months and 2 years). The most common risk factor for ecthyma gangrenosum is neutropenia in immunocompromised patients. In previously healthy patients, immunological evaluation is important to rule out underlying immunodeficiency. Ecthyma gangrenosum in healthy patients has a high mortality rate and early diagnosis and aggressive antibiotic treatment is imperative as it can improve patients' prognosis.

Sepsis por Pseudomonas aeruginosa en un lactante previamente sano / Sepsis due to Pseudomonas aeruginosa in a previously healthy infant

Pseudomonas aeruginosa, is an opportunistic organism widely distributed in both environmental and nosocomial settings. Invasive infections typically occur in immunocompromised patients, but this agent can also produce sepsis in the immunocompetent host. We report the case of an 8 months old infant, previous healthy, who presented septic shock by P. aeruginosa. Lesions of ecthyma gangrenosum in his limbs required surgical debridement. The patient presented transitory neutropenia and reduced C4 levels but subsequent study of immune defects was normal.

Pseudomonas aeruginosa es un microorganismo oportunista de amplia distribución ambiental y nosocomial. Las infecciones invasoras se producen generalmente en pacientes inmunocomprometidos; sin embargo, este agente ocasionalmente puede ser causa de sepsis en pacientes inmunocompetentes. Presentamos el caso de un lactante de 8 meses de edad, sin antecedentes médicos, que cursó con un shock séptico por P. aeruginosa. Durante su evolución presentó lesiones de ectima gangrenoso en sus cuatro extremidades, que requirieron múltiples desbridamientos quirúrgicos. En el período agudo presentó neutropenia y complemento C4 bajo, que normalizó posteriormente. El estudio de inmunidad para descartar inmunodeficiencia fue normal.

Fournier's gangrene: clinical, biochemical, bacteriologic, immunologic study and treatment outcome

Identify Fournier's disease associations, outcome and survival factors. Fournier's gangrene patients [34] were treated between 2003 to 2006. Data were collected about medical history, physical findings, metabolic test, bacteriologic typing, immunologic screening for T cell function, serum IL-2, ICAM-I and gamma IFN with their management. The disease had age range 3-67 years, polymicrobial nature, and low serum albumin [3.3 +/- 0.6mg/dl]. Inadequate T-cell function [18255.3 +/- 1641 CPM] and high ICAM-I, IL-2, gamma IFN [10.5 +/- 0.7, 93.3 +/- 1.6, 131 +/- 2 pg/ml] were detected in Fournier's disease but serum IL-2 was relevant to outcome [P=0.0001]. The survival factors were patients' age [P=0.0001], presentation timing [P=0.001], both disease extent [P=0.0001], septic shock [P=0.01], severe SIRS [P=0.001], serum albumin [P=0.0001] and IL-2. Fournier's disease is consistent with deviated metabolic status and immunologic dissonance, inciting local gangrenous process, these parameters are significant for disease outcome

An unusual presentation of group B streptococcal sepsis

This paper describes the devastating outcome of a neonate who presented with severe late onset group B beta-haemolytic streptococcal (GBS) disease. There were extensive infarcts of the brain and gangrene of the toes. The purpose of this report is to alert healthcare workers of the unusual presentation and that fatal late onset group B beta-haemolytic streptococcal disease may occur despite early and effective management