Harlequin Baby with Ecthyma Gangrenosum

Abstract

Pseudomonas aeruginosa bacteremia or sepsis often occurs in hospitals, affecting mainly children with underlying disease. Ecthyma gangrenosum is classically considered a pathognomonic sign of sepsis by P. aeruginosa. The harlequin baby, a severe variant of ichthyosis, occurs rarely, and these infants are at high risk of cutaneous infections and sepsis. We herein report a harlequin baby who developed ecthyma gangrenosum.

An Extraordinary Cause of the Sucking Difficulty: Ecthyma Gangrenosum

“…A weak mechanical defense barrier and underdeveloped cellular or humoral immunity increased the risk of infection in newborns [ 4 , 5 ]. In the general population lesions are usually present in the gluteal and perineal regions or on the extremities and trunk, but rarely are they found on the face or neck [ 6 ], whereas, in most reported cases of preterm EG, the face is affected as was the case in our patient [ 7 , 8 ]. Even though literature has shown that most children with EG had either previously undetected immunodeficiencies or transient risk factors such as immunosuppressive therapy that predisposed them to the development of the disease, not many newborn cases have been reported [ 9 ].…”

An Ecthyma Gangrenosum Case Due to Staphylococcus in Early Neonatal Period

“…6 Another newborn infant with EG was a harlequin baby and the agent was P. aeruginosa. 16 However, Candida albicans was detected in a 12 day old newborn infant with EG. 17 The predominance of prematurity among newborn cases with EG make us think about immunodeficiency of preterm infants.…”

Ichthyosis Congenita, Harlequin Type: A Fatal Case Report

“…For the first month of life, until the deep fissures heal, sepsis remains a threat and is unfortunately the leading cause of death in these patients [2]. Despite the risk of sepsis, quite interestingly there are no data available which supports antibiotic therapy in these patients and in a case reported by Gunes et al, the patient died on day 21 after being administered antibiotic treatment [9].…”