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1000 Titel
  • An Eschar-like souvenir from a journey to Colombia: Ecthyma gangrenosum as a differential diagnosis of tropical diseases in immunocompromised patients – a case report
1000 Autor/in
  1. Wiedemann, Gabriela |
  2. Schneider, Jochen |
  3. Verbeek, Mareike |
  4. Konukiewitz, Björn |
  5. Spinner, Christoph D. |
  6. Einwächter, Henrik |
  7. Schmid, Roland M. |
  8. Rothe, Kathrin |
1000 Erscheinungsjahr 2021
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2021-04-12
1000 Erschienen in
1000 Quellenangabe
  • 21(1):344
1000 Copyrightjahr
  • 2021
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1186/s12879-021-05998-9 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8042936/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • 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.
1000 Sacherschließung
lokal Aged [MeSH]
lokal Ecthyma gangrenosum
lokal Adenine/therapeutic use [MeSH]
lokal Diagnosis, Differential [MeSH]
lokal Ecthyma/surgery [MeSH]
lokal Immunoglobulins/therapeutic use [MeSH]
lokal Leukemia, Lymphocytic, Chronic, B-Cell/pathology [MeSH]
lokal Male [MeSH]
lokal Leukemia
lokal Ecthyma/diagnosis [MeSH]
lokal Skin Ulcer/microbiology [MeSH]
lokal Case Report
lokal
lokal Ibrutinib
lokal Piperidines/therapeutic use [MeSH]
lokal Adenine/analogs
lokal Skin Ulcer/surgery [MeSH]
lokal Ecthyma/drug therapy [MeSH]
lokal Anti-Bacterial Agents/therapeutic use [MeSH]
lokal Tropical disease
lokal Bacterial and fungal diseases
lokal Humans [MeSH]
lokal Immunocompromised Host [MeSH]
lokal Case report
lokal Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy [MeSH]
lokal Skin ulcer
lokal Pseudomonas aeruginosa/isolation
lokal Colombia [MeSH]
lokal Administration, Intravenous [MeSH]
lokal Bronchoalveolar Lavage Fluid/microbiology [MeSH]
lokal Ecthyma/microbiology [MeSH]
lokal Skin Ulcer/diagnosis [MeSH]
1000 Liste der Beteiligten
  1. https://orcid.org/0000-0001-6138-9791|https://frl.publisso.de/adhoc/uri/U2NobmVpZGVyLCBKb2NoZW4=|https://frl.publisso.de/adhoc/uri/VmVyYmVlaywgTWFyZWlrZQ==|https://frl.publisso.de/adhoc/uri/S29udWtpZXdpdHosIEJqw7Zybg==|https://frl.publisso.de/adhoc/uri/U3Bpbm5lciwgQ2hyaXN0b3BoIEQu|https://frl.publisso.de/adhoc/uri/RWlud8OkY2h0ZXIsIEhlbnJpaw==|https://frl.publisso.de/adhoc/uri/U2NobWlkLCBSb2xhbmQgTS4=|https://frl.publisso.de/adhoc/uri/Um90aGUsIEthdGhyaW4=
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