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Archives de pédiatrie
Volume 22, n° 6
pages 616-620 (juin 2015)
Doi : 10.1016/j.arcped.2015.03.006
Received : 4 April 2014 ;  accepted : 11 Mars 2015
Ecthyma gangrenosum: A manifestation of community-acquired Pseudomonas aeruginosa septicemia in three infants
Ecthyma gangrenosum et septicémie communautaire à Pseudomonas aeruginosa chez trois nourrissons
 

L. Gargouri a, , b , I. Maaloul b, c, T. Kamoun b, c, B. Maalej a, b, F. Safi a, b, I. Majdoub a, b, M. Hachicha b, c, A. Mahfoudh a, b
a Department of pediatrics, pediatric emergency and intensive care, Hedi Chaker Hospital, route El Aïn, 3029 Sfax, Tunisia 
b Faculty of Medecine, Sfax, Tunisia 
c Pediatric department, Hedi Chaker Hospital, Sfax, Tunisia 

Corresponding author.
Summary
Objectives

Pseudomonas aeruginosa sepsis usually carries a high mortality rate in immunocompromised children. Ecthyma gangrenosum is a known cutaneous manifestation due mainly to Pseudomonas infection with or without septicemia. We describe clinical, biological, and therapeutic data.

Patients and methods

Of those children admitted to the pediatric intensive care unit, three pediatric cases of community-acquired P. aeruginosa septicemia associated with ecthyma gangrenosum were retrospectively reviewed.

Results

The three patients were aged 5 months, 9 months, and 1 year. Underlying hypogammaglobulinemia was detected in the oldest patient. Pseudomonas aeruginosa was isolated in all patients in blood and once in cultures of skin lesions and endotracheal aspirate. Two deaths occurred due to septic shock and multisystem organ failure despite numerous aggressive resuscitation attempts.

Conclusions

P. aeruginosa sepsis should be treated as early as possible. Recognition of ecthyma gangrenosum allows early diagnosis and prescription of adequate antibiotic therapy without awaiting blood culture reports.

The full text of this article is available in PDF format.
Résumé

L’ecthyma gangrenosum est une manifestation cutanée caractéristique des infections par Pseudomonas avec ou sans septicémie. Nous présentons trois cas de septicémie communautaire à P. aeruginosa associée à un ecthyma gangrenosum chez des nourrissons âgés respectivement de cinq mois, neuf mois et un an. Une hypogammaglobulinémie a été identifiée chez l’enfant le plus âgé. P. aeruginosa a été isolé chez tous les enfants dans le sang. Deux décès sont survenus par choc septique. La survenue d’un ecthyma gangrenosum chez l’enfant doit faire évoquer une infection invasive à P. aeruginosa et conduire à l’instauration en urgence d’une antibiothérapie probabiliste adaptée.

The full text of this article is available in PDF format.


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