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At least 37 records · Page 2Linked to original sources
PubMed2005

Ecthyma gangrenosum: a rare cutaneous manifestation caused by pseudomonas aeruginosa without bacteraemia in a leukaemic patient--a case report.

Ecthyma gangrenosum is a rare and invasive cutaneous infection caused by Pseudomonas aeruginosa in the majority of cases, typically affecting immunocompromised patients, particularly those with neutropenia. We report a rare case of ecthyma gangrenosum in the absence of bacteraemia presenting as a solitary necrotic ulcer in a female patient with acute lymphoblastic leukaemia. A culture from the ecthyma lesion revealed the presence of Pesudomonas aeruginosa, but the results of repeated blood cultures were negative. The patient responded well to amikacin to which the isolate was susceptible in vitro. Considering high rate of mortality, early diagnosis and prompt effective treatment is mandatory.

Adult↗
PubMed1981

Contagious ecthyma in Alaskan musk-oxen and Dall sheep.

In 1976 and 1977, a disease resembling contagious ecthyma was seen in captive musk-oxen (Ovibos moschatus) in Alaska. A similar disease occurred in 1977 in captive Dall sheep (Ovis dalli). Paravaccinia viruses were detected by electron microscopy and isolated in cell cultures from both species. Experimental inoculation in susceptible and immune domestic sheep (Ovis aries) plus fluorescent antibody tests with ecthyma-immune conjugate indicated that the isolate was contagious ecthyma virus.

Alaska↗
PubMed1979

Ecthyma gangrenosum: survival with individualized antibiotic therapy.

Five burn patients with ecthyma gangrenosum were treated with gentamicin sulfate in an individualized aminoglycoside regimen. Dosages greater than the currently recommended 3 to 5 mg/kg/day were necessary and ranged from 15 to 30 mg/kg/day. These increased dosages cannot be used routinely but only as serum level data indicate the need. Four of the five patients survived their course of ecthyma gangrenosum. The single fatality received a much smaller dosage of gentamicin as compared with the other four patients. No ototoxic or nephrotoxic reactions were noted in any of the patients.

Adolescent↗
PubMed1978

Serologic and cross-immunity studies with contagious ecthyma and goat pox virus isolates from the western United States.

Contagious ecthyma and goat pox viruses were isolated from goats affected with papulopustular epidermal lesions. Results of in vitro serum neutralization and in vivo cross-immunity studies indicate that these contagious ecthyma and goat pox isolates from the western United States are antigenically dissimilar and that exposure or vaccination with one isolate could not be used as a method of inducing immunity to the other. Exposure to each isolate conferred immunity to re-exposure with the same agent. The serum neutralization test indicates that the severity and persistance of lesions to goat pox infection influences the nature of the antibody response to an initial exposure.

Animals↗
PubMed1999

Perineal reconstruction for severe sequela of ecthyma gangrenosum: report of a case.

Ecthyma gangrenosum is a cutaneous gangrenous disorder which usually follows Pseudomona aeruginosa infection and is found mainly in immunosuppressed children. We describe a case of a five-year-old female with leukemia with a severe perineal ecthyma gangrenosum resulting in a cloaca-like deformity. One year later a perineoplasty with puborectalis interposition and overlapping external anal sphincteroplasty was successfully performed, achieving satisfactory continence.

Child, Preschool↗
PubMed1986

Ecthyma gangrenosum in a kidney transplant recipient with Pseudomonas septicemia.

This report describes a renal transplant recipient in whom Pseudomonas septicemia and ecthyma gangrenosum developed within days of renal transplantation. Microscopic skin sections showed perivascular bacillary invasion. Pseudomonas organisms were cultured and microscopically visualized in sections from the transplanted kidney. Although cultures from the donor kidney preservation perfusate fluid showed no growth, Pseudomonas aeruginosa was found in the recipient's urine, blood, and peritoneal fluid. The recipient's course was complicated by septic shock, cardiopulmonary arrest, coma, and extensive skin lesions; but his condition improved with appropriate antibiotic therapy, wound debridement, and an aggressive rehabilitative program. He is now a candidate for retransplantation. This is the first known case of ecthyma gangrenosum in a renal transplant recipient.

Adult↗
PubMed1989

In vivo and in vitro characteristics of contagious ecthyma virus isolates: host response mechanism.

Three Vero cell culture-adapted contagious ecthyma virus (CEV) isolates were compared by plaque morphology, ability to induce vesicles in skin and in vivo growth curve characteristics by sampling sequentially experimental skin lesions produced in four sheep and one goat. Two of the isolates (CEV-29A and CEV-378) were from outbreaks of ecthyma in sheep and one (CEV-102) from a human case of orf. When replicating in Vero cells, the viruses exhibited similar growth parameters, but were distinguishable from each other on the basis of plaque morphology. In vivo latent periods for these isolates were 48 h (CEV-29A), 96 h (CEV-102), and 120 h (CEV-378). When isolates CEV-102 and CEV-29A were passaged into another sheep, they produced similar patterns of growth. Isolate CEV-102 produced the highest infectivity titer [1.4 X 10(9) plaque forming units (PFU) g-1], followed by CEV-29A (6.8 X 10(7) PFU g-1) and CEV-378 (2.5 X 10(7) PFU g-1). In addition, these viruses varied in their ability to induce vesicle formation. Virus was no longer detectable at the inoculation sites at 288 h post-infection (PI). We conclude that plaque morphology, ability to induce vesicle formation in the skin and growth curves in the skin can be considered as important criteria to differentiate CEV isolates. A comparison of the growth curves of CEV-378 in the skin of sheep and goats suggested differences in virus-host interaction between the two animal species. Since intravenous injection of 1 X 10(9) PFU of CEV failed to produce lesions in the sham-scarified skin of sheep, virus spread via the hematogenous route from one site to another appears unlikely. No virus-neutralizing antibody or interferons were found in serum samples or in skin homogenates collected between 0 and 24 days PI. Virus-neutralizing antibody was present in the circulation as late as 24 days PI. Lymphocytes collected from CEV-exposed sheep as early as 12 days PI responded specifically to stimulation with CEV antigen. As this was about the time when infectious virus disappeared from the sites, we assume that cell-associated immune mechanisms may play a larger role in virus clearance from skin lesions than virus-neutralizing antibody.

Animals↗
PubMed1995

Immune responses of the camel (Camelus dromedarius) to contagious ecthyma (Orf) virus infection.

An enzyme-linked immunosorbent assay (ELISA) was developed together with a western blotting technique for the detection of total and specific IgG and IgM antibodies to the contagious ecthyma (orf) virus in camel (Camelus dromedarius) sera and for identifying the seroreactive antigens of the virus. An outbreak of generalised contagious ecthyma in camels was diagnosed for the first time in Libya; the seropositivity rate in a herd with clinically affected camels was 37.9% (and was related to clinical signs) and in apparently normal herds was 0% to 6.8%. Two viral antigenic determinants (22 and 40 kDa) were shared by the western blotting patterns of all the positive camel sera tested, another viral antigenic component of 28 kDa was shared by the positive sera with high ELISA titres. Very close similarity was seen with the western blot of orf-positive sheep sera. It is considered that the ELISA technique was valid for orf serodiagnosis in the camel and could be usefully applied to other species at risk of orf infection.

Animals↗
PubMed2004

[Ecthyma gangrenosum caused by Pseudomonas stutzeri with bacteraemia and systemic vascularitis].

INTRODUCTION: Ecthyma gangrenosum is a cutaneous manifestation of Pseudomonas infections. This condition may be associated with bacteraemia but can also occur in the absence of bacteraemia. EXEGESIS: The authors report the case of a 66-year-old woman presented with necrotic ulcerations on the face associated with fever, arthralgia, myalgia, fatigue and neutropenia. Blood cultures and skin cultures were positive for Pseudomonas stutzeri. Her condition improved under appropriate antibiotic therapy. However, the patient further developed clinical and biological symptoms of systemic vasculitis and mixed cryoglubulinemia. Complete healing was finally obtained after a course of corticosteroids. CONCLUSION: Ecthyma gangrenosum should be suspected in people who have typical clinical presentation. This disease could sometimes be associated with systemic vasculitis.

Bacteremia↗
PubMed2004

Orbital cellulitis, panophthalmitis, and ecthyma gangrenosum in an immunocompromised host with pseudomonas septicemia.

PURPOSE: To describe a case of Pseudomonas aeruginosa septicemia complicated by orbital cellulitis, panophthalmitis, and ecthyma gangrenosum. DESIGN: Observational case report. METHODS: An immunosuppressed 62-year-old man developed an unusual skin rash and a painful, swollen right eye with decreased vision. He had myelodysplastic syndrome and P. aeruginosa septicemia. The skin rash manifested as ecthyma gangrenosum. Metastatic orbital cellulitis and panophthalmitis was diagnosed. RESULTS: Despite intravitreal and topical gentamicin, the patient eventually required enucleation. CONCLUSIONS: This case represents a rare combination of events: an immunocompromised man developed pneumonia, P. aeruginosa septicemia, and endogenous seeding of the Pseudomonas to the skin, orbit, and eye. Early recognition of endogenous ophthalmic disease is imperative. The prognosis of combined orbital cellulitis and panophthalmitis is poor.

Bacteremia↗
PubMed1999

Ecthyma gangrenosum as a very early herald of acute lymphoblastic leukaemia.

Ecthyma gangrenosum is a manifestation of cutaneous infection by Pseudomonas aeruginosa. The lesion may be associated with immunocompromise, in particular neutropenia. We present a case of ecthyma gangrenosum in a previously healthy child who 3 months later developed acute lymphoblastic leukaemia; we use this to illustrate the lack of information on the growth rate of malignant and premalignant leukaemic cells in children.

Antibodies, Neoplasm↗
PubMed2000

Compartment syndrome in a patient with X-linked agammaglobulinaemia and ecthyma gangrenosum. Case report.

Compartment syndrome is a surgical emergency that requires immediate decompression. We know of no documented cases that describe ecthyma gangrenosum as a primary cause of compartment syndrome. We present a case of a baby with x-linked agammaglobulinaemia who developed compartment syndrome associated with systemic Pseudomonas aeruginosa infection and ecthyma gangrenosum of the leg. He was treated by debridement and fasciotomies followed by primary closure and skin grafting and made an uneventful recovery.

Agammaglobulinemia↗
PubMed1988

Bacteremia and ecthyma caused by Streptococcus pyogenes in a patient with acquired immunodeficiency syndrome.

Ecthyma is an ulcerated form of impetigo due to Streptococcus pyogenes, seen primarily in children with poor hygiene. The authors report a homosexual man with acquired immunodeficiency syndrome (AIDS) who developed severe ecthyma and bacteremia caused by S. pyogenes. Opsonizing antibody to the M protein of S. pyogenes is important in immunity to this organism. Patients with AIDS may have defective humoral immunity as well as defective cellular immunity, and such a defect may have rendered this patient abnormally susceptible to severe infection with S. pyogenes.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Pseudomonas aeruginosa cellulitis and ecthyma gangrenosum in immunocompromised children.

Pseudomonas aeruginosa skin infections are generally considered to be secondary manifestations of disseminated disease. A retrospective analysis of all cases of P. aeruginosa skin infections seen at St. Jude Children's Research Hospital since 1962 revealed 16 episodes of the infection (ecthyma gangrenosum, 8 episodes, 7 patients; cellulitis, 8 episodes, 7 patients) in which blood cultures were uniformly negative for P. aeruginosa. All cases were identified while the patients were receiving ambulatory care. Five episodes developed while the patients' neutrophil counts were greater than 1 x 10(9) cells/liter. Eight patients had acute lymphoblastic leukemia, 2 had acute myeloid leukemia, 2 had aplastic anemia, 1 had transient agranulocytosis and 1 had cyclic neutropenia. There were no solid tumor patients. Although patients received different antibiotic combinations, all had resolutions of their lesions without fatal complications. Patients diagnosed as having cellulitis required a mean of 9.2 days of treatment with intravenous antibiotics, as compared with 17.8 days for those with ecthyma gangrenosum (P less than 0.05 by the Wilcoxon test). These observations show that P. aeruginosa skin infections can develop in the absence of bacteremia in immunocompromised children.

Adolescent↗
PubMed1988

Treatment of impetigo and ecthyma. A comparison of sulconazole with miconazole.

In a randomized, double-blind, parallel comparative study of 80 patients, impetigo and ecthyma were treated effectively by sulconazole nitrate 1% cream and miconazole nitrate 2% cream applied to lesions twice daily for 14 days. When treatment began, bacterial cultures from all pyodermal lesions yielded Group A beta-hemolytic streptococci or pathogenic staphylococci. Among the 32 sulconazole-treated impetigo patients, bacterial cultures from 26 (69%) were negative by treatment day 4, and those from all 32 (100%) were negative by treatment day 7; among the 34 miconazole-treated impetigo patients, cultures from 17 (50%) were negative by treatment day 4, cultures from 32 (94.1%) were negative by treatment day 7, and cultures from 29 (97%) were negative by treatment day 14. Each treatment promptly relieved the pyodermal signs (crusts, vesicles, pustules, bullae, and exudate). Both agents were considered to be safe and effective medications for treating impetigo and ecthyma.

Double-Blind Method↗
PubMed1986

Pseudomonas maltophilia exoenzyme activity as correlate in pathogenesis of ecthyma gangrenosum.

Ecthyma gangrenosum has not been described during the course of blood stream invasion with Pseudomonas maltophilia, although it occurs with a 30% frequency in Pseudomonas aeruginosa septicemia. We isolated P. maltophilia from the blood and an ecthyma lesion in a leukemic patient. The organism was an avid protease and elastase producer and hence mimicked the exoenzyme profile of invasive P. aeruginosa. The patient responded to moxalactam to which the isolate was susceptible in vitro. On the basis of this report, P. maltophilia may be included among an emerging number of gram-negative bacillary species capable of producing severe cutaneous manifestations of bacteremia.

Aged↗
PubMed1994

Outbreaks of contagious ecthyma in camels (Camelus dromedarius) in the Turkana district of Kenya.

Mortality among camel calves (Camelus dromedarius) is one of the most serious problems faced by camel herdsmen and, although there are several reasons for this mortality, diseases play a major role. In an investigation of outbreaks of contagious ecthyma in camels in the Turkana district of Kenya, four outbreaks were detected involving only camel calves. The principal lesions were distinct or largely coalesced pustules on the mouth, nose and muzzle. Direct electron microscopy of infected scabs was used to confirm the presence of the virus. Secondary infection of the pustules was common in affected calves. Morbidity in affected herds was 100%, with no adult involvement. Affected calves were unable to suckle properly. In all outbreaks, there was a concurrent outbreak of contagious pustular dermatitis in goat kids in the same household. Contagious ecthyma is an important disease in camels, contributing to calf debility and eventually to high calf mortality.

Animals↗
PubMed1977

Aeromonas hydrophila septicaemia producing ecthyma gangrenosum in a child with leukaemia.

A 4-year-old girl with leukaemia developed fever and ecthyma gangrenosum. Aeromonas hydrophila was isolated from blood and skin lesions. Ecthyma gangrenosum is often considered pathognomonic of Pseudomonas aeruginosa septicaemia. As is evident from the case reported, it may also result from infection with A. hydrophila, which has different antibiotic sensitivities, and which is now being recognised more frequently as a serious pathogen in immunosuppressed patients.

Child, Preschool↗