Considerations in a Previously Healthy Child
Considerations in a Previously Healthy Child
Ecthyma gangrenosum is a skin lesion that is most commonly caused by Pseudomonas aeruginosa. Although ecthyma gangrenosum usually develops in patients with underlying immunodeficiencies or chronic diseases, there have been reports of its appearance in previously healthy children. A review of such patients in the English literature showed that most of them had either previously undetected immunodeficiencies or transient risk factors that predisposed them to the development of ecthyma gangrenosum. We report a patient without apparent antecedent predisposing risk factors for ecthyma gangrenosum who developed chronic neutropenia 1 week after presentation. It is important for the primary care provider to recognize ecthyma gangrenosum, treat it with appropriate antimicrobial agents and investigate the patient for occult immunodeficiencies.
Ecthyma gangrenosum is a skin lesion that results from either primary skin infection hematogenous seeding by a bacterium. It is most commonly caused by infection with P. aeruginosa, which has a high risk of fatality when the infection is systemic. Ecthyma gangrenosum is clinically important not only because of its potentially fatal prognosis, but also because it signals the presence of a predisposing condition. The most common risk factor is neutropenia in the context of either a malignancy or immunosuppressive therapy. Rarely ecthyma gangrenosum has been reported in previously healthy individuals. Most of these healthy patients had a concurrent viral infection, received recent antibiotic therapy or were neutropenic before the development of ecthyma gangrenosum. We report a case of ecthyma gangrenosum in an 8-month-old female infant without apparent antecedent predisposing factors who developed chronic neutropenia 1 week after presentation.
Ecthyma gangrenosum is a skin lesion that is most commonly caused by Pseudomonas aeruginosa. Although ecthyma gangrenosum usually develops in patients with underlying immunodeficiencies or chronic diseases, there have been reports of its appearance in previously healthy children. A review of such patients in the English literature showed that most of them had either previously undetected immunodeficiencies or transient risk factors that predisposed them to the development of ecthyma gangrenosum. We report a patient without apparent antecedent predisposing risk factors for ecthyma gangrenosum who developed chronic neutropenia 1 week after presentation. It is important for the primary care provider to recognize ecthyma gangrenosum, treat it with appropriate antimicrobial agents and investigate the patient for occult immunodeficiencies.
Ecthyma gangrenosum is a skin lesion that results from either primary skin infection hematogenous seeding by a bacterium. It is most commonly caused by infection with P. aeruginosa, which has a high risk of fatality when the infection is systemic. Ecthyma gangrenosum is clinically important not only because of its potentially fatal prognosis, but also because it signals the presence of a predisposing condition. The most common risk factor is neutropenia in the context of either a malignancy or immunosuppressive therapy. Rarely ecthyma gangrenosum has been reported in previously healthy individuals. Most of these healthy patients had a concurrent viral infection, received recent antibiotic therapy or were neutropenic before the development of ecthyma gangrenosum. We report a case of ecthyma gangrenosum in an 8-month-old female infant without apparent antecedent predisposing factors who developed chronic neutropenia 1 week after presentation.
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