Colostomy for Perianal Sepsis With Ecthyma Gangrenosum in Immunocompromised Children.

Abstract

BACKGROUND:

Perianal sepsis with ecthyma gangrenosum is a severe and potentially mutilating complication in immunocompromised children. Therapies include antimicrobial treatment, incision and drainage, generous tissue debridement, and skin transplantation.

PROCEDURE:

We describe 3 children with acute lymphoblastic leukemia having sepsis with Pseudomonas aeruginosa in febrile neutropenia and severe perianal infections treated relatively early with a protective colostomy. Indications for colostomy were nonhealing wounds, and ceaseless pain.

RESULTS:

All patients showed a rapid reduction of pain. Complete wound healing was seen in 2 patients, and considerable pain reduction and increased quality of life were seen in a third patient during palliative care.

CONCLUSIONS:

These results suggest that a protective colostomy should be considered early in the management of immunocompromised children with ecthyma gangrenosum.

• Authors: Raphael N Vuille-dit-Bille, Christoph Berger, Martin Meuli, Michael A Grotzer
• Journal: Journal of pediatric hematology/oncology (J Pediatr Hematol Oncol) Vol. 38 Issue 1 Pg. 53-7 (Jan 2016) ISSN: 1536-3678 [Electronic] United States
• PMID: 25757025 (Publication Type: Case Reports, Journal Article)

Topics

• Anal Canal (pathology)
• Child, Preschool
• Colostomy (methods)
• Ecthyma (immunology, surgery)
• Febrile Neutropenia (etiology)
• Humans
• Immunocompromised Host
• Male
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (complications)
• Pseudomonas Infections (immunology)
• Sepsis (immunology, surgery)