An Eschar-like souvenir from a journey to Colombia: Ecthyma gangrenosum as a differential diagnosis of tropical diseases in immunocompromised patients - a case report.
Background: Ecthyma gangrenosum (EG) is a cutaneous infectious disease characterized by eschar-like skin ulcers typically caused by Pseudomonas aeruginosa. Here, we report a case of relapsing EG in a patient who had returned from a trip to Colombia, thus establishing EG as an important differential...
| Publicado en: | BMC Infectious Diseases Vol. 21; no. 1; pp. 1 - 7 |
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| Autores principales: | , , , , , , , |
| Formato: | case study Journal Article |
| Publicado: |
BioMed Central
4/12/2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=149786342&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 149786342 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712334 1CHU jtl: BMC Infectious Diseases issn: 14712334 maglogo: N pubinfo: dt: 4/12/2021 vid: 21 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 149786342 149786342 NLM33845789 149786342 10.1186/s12879-021-05998-9 NLM33845789 149786342 ppf: 1 ppct: 6 formats: tig: atl: An Eschar-like souvenir from a journey to Colombia: Ecthyma gangrenosum as a differential diagnosis of tropical diseases in immunocompromised patients - a case report. aug: au: Wiedemann, Gabriela M. Schneider, Jochen Verbeek, Mareike Konukiewitz, Björn Spinner, Christoph D. Einwächter, Henrik Schmid, Roland M. Rothe, Kathrin affil: Department of Internal Medicine II, University hospital rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany sug: subj: Skin Ulcer Diagnosis Pyoderma Diagnosis Pyoderma Drug Therapy Skin Ulcer Microbiology Antibiotics Therapeutic Use Immunoglobulins Therapeutic Use Administration, Intravenous Skin Ulcer Surgery Leukemia, Lymphocytic, Chronic Drug Therapy Purines Analogs and Derivatives Pyoderma Microbiology Purines Therapeutic Use Pseudomonas Colombia Immunocompromised Host Aged Male Body Fluids Microbiology Pyoderma Surgery Piperidines Therapeutic Use Leukemia, Lymphocytic, Chronic Pathology Diagnosis, Differential Scales Aged: 65+ years Male ab: Background: Ecthyma gangrenosum (EG) is a cutaneous infectious disease characterized by eschar-like skin ulcers typically caused by Pseudomonas aeruginosa. Here, we report a case of relapsing EG in a patient who had returned from a trip to Colombia, thus establishing EG as an important differential diagnosis of tropical diseases, and demonstrating that even long-term antibiotic treatment can result in only partial remission of EG.Case Presentation: A 77-year-old man with underlying chronic lymphocytic leukemia (CLL) on ibrutinib treatment was admitted because of a superinfected mosquito bite on the left ear and multiple partially necrotic skin lesions disseminated all over the entire body five days after returning from a trip to Colombia. The initial clinical suspicion of a tropical disease (leishmaniosis, systemic mycosis, or others) could not be confirmed. During the diagnostic workup, microbiological cultures of the skin biopsies and bronchoalveolar lavage revealed Pseudomonas aeruginosa, leading to a diagnosis of EG. Initial antibiotic treatment resulted in partial remission. However, the patient had to be re-admitted due to a relapse 3-4 weeks after the first episode. Finally, the patient was successfully treated with a combined approach consisting of antibiotics, recurrent surgical incisions, and administration of immunoglobulins.Conclusions: In conclusion, EG should be considered as a differential diagnosis in immunosuppressed patients presenting with eschar-like skin ulcers. A combined treatment approach seems to be the best choice to achieve clinical cure and avoid relapse. pubtype: Academic Journal doctype: case study Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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