| Abstract | Toxic epidermal necrolysis and Stevens-Johnson syndrome are a spectrum of disease characterized by a delayed hypersensitivity reaction that involves the skin and mucous membranes and typically is associated with either recent upper respiratory infection or with certain medications. Ecthyma gangrenosum is a rare necrotizing vasculitis that most commonly affects immunocompromised and burn patients and is often a sequela of Pseudomonas aeruginosa bacteremia. The cutaneous lesions of ecthyma gangrenosum are characterized by an erythematous halo surrounding a dark gray or black nodule. P. aeruginosa preferentially invades the venules, resulting in secondary thrombosis of the arterioles, tissue edema, and separation of the epidermis. Management of ecthyma gangrenosum includes systemic treatment with antipseudomonal antibiotics and débridment of the lesions, as well as improving the patient's immune status if possible. We present a case of a patient admitted to the burn unit for toxic epidermal necrolysis who developed pseudomonal bacteremia with ecthyma gangrenosum. |
| Authors | Douglas M Downey, Meghan C O'Bryan, Steve D Burdette, Johnson R Michael, Jonathan M Saxe
(Affiliation: Department of Surgery, Wright State University School of Medicine, Dayton, Ohio, USA.)
|
| Journal | Journal of burn care & research : official publication of the American Burn Association
(J Burn Care Res)
2007 Jan-Feb
Vol. 28
Issue 1
Pg. 198-202
ISSN: 1559-047X United States |
| PMID | 17211226
(Publication Type: Case Reports, Journal Article)
|
| Chemical References |
- Anti-Infective Agents
- Sulfamethoxazole
- Trimethoprim
|
| Topics |
- Anti-Infective Agents
(adverse effects)
- Bacteremia
(microbiology)
- Debridement
- Ecthyma
(complications, therapy)
- Epidermal Necrolysis, Toxic
(complications, therapy)
- Fatal Outcome
- Female
- Gangrene
(microbiology, therapy)
- Humans
- Middle Aged
- Pseudomonas aeruginosa
(isolation & purification)
- Staphylococcus aureus
(isolation & purification)
- Sulfamethoxazole
(adverse effects)
- Trimethoprim
(adverse effects)
|
