Perivascular Basophilic Rim as a Histopathological Clue of Cutaneous Pseudomona aeruginosa Sepsis

Blue Toe in an Oncological Patient: Answer

“…Although infrequent, the presence of a perivascular basophilic rim, corresponding to gram-negative bacilli within and around the vessels, is considered characteristic. 7,9,10 The pathogenic mechanism of ecthyma gangrenosum is thought to result from direct damage to the media and adventitia of the cutaneous arteries and veins, by the culprit organisms. 2 In bacteremic forms, lesions occur due to hematogenous metastatic spread of involved organisms into the skin, whereas in nonbacteremic ecthyma gangrenosum, lesions may represent the primary site of entry of the infection or a transient hematogenous dissemination resulting in a limited number of lesions.…”

“…Although infrequent, the presence of a perivascular basophilic rim, corresponding to gram-negative bacilli within and around the vessels, is considered characteristic. 7,9,10…”

Cutaneous lymphohistiocytic infiltrates with foamy macrophages: A novel histopathological clue to Stenotrophomonas maltophilia septicemia

“…The best‐known cutaneous manifestation of septicemia in the skin is the so‐called “septic vasculitis,” a variant of small‐vessel vasculitis characterized by marked vascular damage induced by circulating pathogens and widespread thrombotic changes 1 . Cutaneous septic vasculitis may be observed secondarily to different bacterial infections, including Neisseria meningitidis , Neisseria gonorrhoeae , Pseudomonas aeurignosa , Staphylococcus aureus , as well as certain rickettsioses 1‐8 . Depending on the infectious agent, the temporal evolution of the infection (acute vs subacute/chronic), and the host immune status, the ensuing histopathological picture may vary, featuring different combinations of (a) inflammatory leukocytoclastic vasculitis, (b) occlusive thrombosis of small vessels, and (c) subepidermal or intraepidermal pustulation 1,3,5 .…”

“…1 Cutaneous septic vasculitis may be observed secondarily to different bacterial infections, including Neisseria meningitidis, Neisseria gonorrhoeae, Pseudomonas aeurignosa, Staphylococcus aureus, as well as certain rickettsioses. [1][2][3][4][5][6][7][8] Depending on the infectious agent, the temporal evolution of the infection (acute vs subacute/chronic), and the host immune status, the ensuing histopathological picture may vary, featuring different combinations of (a) inflammatory leukocytoclastic vasculitis, (b) occlusive thrombosis of small vessels, and (c) subepidermal or intraepidermal pustulation. 1,3,5 The term "septic vasculopathy" has been used for cases showing vascular occlusive phenomena prevailing over the inflammatory vasculitic component.…”

“…[1][2][3][4][5][6][7][8] Depending on the infectious agent, the temporal evolution of the infection (acute vs subacute/chronic), and the host immune status, the ensuing histopathological picture may vary, featuring different combinations of (a) inflammatory leukocytoclastic vasculitis, (b) occlusive thrombosis of small vessels, and (c) subepidermal or intraepidermal pustulation. 1,3,5 The term "septic vasculopathy" has been used for cases showing vascular occlusive phenomena prevailing over the inflammatory vasculitic component. 9,10 At the end of this spectrum, there is the disseminated intravascular coagulation (DIC) related mostly to Neisseria meningitidis sepsis, causing vascular occlusions of dermal vessels without inflammatory infiltrate.…”