Ecthyma gangrenosum as first manifestation of acute leukemia

Puzas, Álvaro Iglesias; Cebey, Ana Batalla; Menéndez, Ángeles Flórez

doi:10.1016/j.medcle.2017.09.012

Cited by 3 publications

(5 citation statements)

References 2 publications

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“…They include ceftazidime, amoxicillin-clavulanate and piperacilline/tazobactam; the latter being used in our cases (2,23). As we identified GAS and SA, we Surgical debridement of the wounds or plastic surgery might be necessary and some authors suggest to use GM-CSF in case of EG in neutropenic patient (2,7,10,12,13).…”

Section: Discussionmentioning

confidence: 91%

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Echtyma gangrenosum caused by coinfection with group A Streptococcus and Staphylococcus aureus: an emerging etiology? Case reports and literature review

Trillig

Deyi

Youatou

et al. 2019

Acta Clinica Belgica

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Ecthyma gangrenosum (EG) is a potentially lethal skin infection, most commonly due to Pseudomonas aeruginosa with bacteremic dissemination and affecting mostly immunocompromised patients. We present two cases of EG in two men in Belgium recently admitted to our hospital, caused by a suspected coinfection by group A Streptococcus and Staphylococcus aureus, with a cutaneous dissemination, in which multiple impetigo lesions were the portal of entry. The first patient had no risk factors nor immunodeficiency but the second was a homeless man with drug and alcohol abuse and advanced HIV infection. Early management of the condition is crucial, with initial broad spectrum antibiotherapy, rapidly narrowed down to the germs identified and skin lesion debridement if necessary. Any immunocompromising condition must be ruled out in any patient suffering from EG.

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Section: Discussionmentioning

confidence: 91%

“…presented with sepsis (2). Different conditions have been described as risk factors associated to EG, including chronic alcoholism, malnutrition, chemotherapy treatment, long course of antibiotherapy, HIV infection, kidney transplant, but most frequently malignant hemopathy (1,(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Echtyma gangrenosum caused by coinfection with group A Streptococcus and Staphylococcus aureus: an emerging etiology? Case reports and literature review

Trillig

Deyi

Youatou

et al. 2019

Acta Clinica Belgica

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“…In addition, 4 cases of acute leukaemia presenting with EG (2 adult cases and 2 pediatric cases) have been reported in the literature. [2][3][4][5] In a previous study, among patients with P aeruginosa EG, although most patients had underlying conditions such as leukaemia, lymphoma, other malignant diseases, or organ transplantation, approximately 40% patients were immunocompetent. [1] Physicians unfamiliar with this disease can find it difficult to diagnose cases such as ours, in which the patient had not been diagnosed with any malignant diseases at the time of admission.…”

Section: Discussionmentioning

confidence: 93%

“…In our case, the presentation of EG and bacteremia caused by P aeruginosa was associated with a diagnosis of APL, suggesting that EG can present as the first manifestation of an underlying immunosuppression. In addition, 4 cases of acute leukaemia presenting with EG (2 adult cases and 2 pediatric cases) have been reported in the literature [2–5] . In a previous study, among patients with P aeruginosa EG, although most patients had underlying conditions such as leukaemia, lymphoma, other malignant diseases, or organ transplantation, approximately 40% patients were immunocompetent [1] .…”

Section: Discussionmentioning

confidence: 99%

“…Ecthyma gangrenosum (EG) is an uncommon cutaneous infection usually associated with Pseudomonas aeruginosa bacteremia in immunocompromised patients, particularly those with underlying malignant diseases. [1,2] Despite its rarity, especially in immunocompetent or nondiagnosed immunodeficiency patients, EG can present as the first manifestation of an underlying immunosuppression. [3][4][5][6] Here, we have reported a case of acute promyelocytic leukaemia (APL) presenting with EG as the first manifestation.…”

Section: Introductionmentioning

confidence: 99%

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Acute myeloid leukaemia presenting with ecthyma gangrenosum as the first manifestation

Hadano

Yoshida-Sakai²,

Imamura³

et al. 2021

Medicine

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Rationale Ecthyma gangrenosum (EG) is an uncommon cutaneous infection usually associated with Pseudomonas aeruginosa bacteremia in immunocompromised patients, particularly those with underlying malignant diseases. Despite its rarity, especially in immunocompetent or nondiagnosed immunodeficiency patients, EG can present as the first manifestation of an underlying immunosuppression. Patient concerns A 42-year-old Japanese man was admitted to our hospital with a 3-day history of a painless red macule on his right forearm and fever. Diagnoses Blood culture on admission revealed the presence of Pseudomonas aeruginosa , whereas pus culture of the skin lesion showed Pseudomonas aeruginosa and methicillin-susceptible Staphylococcus aureus positivity. Interventions Additional bone marrow aspirate examination and immunophenotyping were performed to confirm the diagnosis of acute promyelocytic leukaemia with PML-retinoic acid alpha receptor. Outcomes The patient was successfully treated with a 14-day course of antibiotics, and no evidence of relapse was noted. The patient achieved complete remission after treatment for acute promyelocytic leukaemia. Lessons It should be kept in mind that EG is an important cutaneous infection that is typically associated with P aeruginosa bacteremia and the presence of underlying immunodeficiency, such as acute leukaemia.

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