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May 1992

Xanthomonas (Formerly Pseudomonas) maltophilia-Induced Cellulitis in a Neutropenic Patient

Author Affiliations

Service Clinique des Maladies du Sang; Clinique des Maladies Cutanées Guillaume Arlet Service de Bactériologie et Virologie Hôpital Saint-Louis 1 Ave Claude Vellefaux 75010 Paris Cedex 10, France

Arch Dermatol. 1992;128(5):702-704. doi:10.1001/archderm.1992.01680150136028

To the Editor.—  Cellulitis is a life-threatening soft-tissue infection frequently associated with severe systemic toxic reactions. In immunocompromised hosts, skin infections are often related to opportunistic agents. Infection with Xanthomonas (formerly Pseudomonas) maltophilia, a nosocomial gramnegative bacillus, is thought to emerge because of prolonged therapy with broad-spectrum antibiotics.1 We describe a woman undergoing chemotherapy for acute myelogenous leukemia who had perineal gangrenous cellulitis induced by Xmaltophilia and who also had neutropenia.

Report of a Case.—  A 31-year-old woman in complete remission from acute myelogenous leukemia (type 4, French-American-British Cooperative Group classification) received her last course of high-dose consolidation chemotherapy with mitoxantrone, cytarabine, and etoposide. Pancytopenia appeared at day 9 of therapy (leukocyte count, 4.0 × 109/L). Intravenous administration of piperacillin, netilmicin, and vancomycin was instituted at day 10 for treatment of bacteremia caused by Streptococcus mitis.At day 18, jaundice, abdominal pain, and diarrhea developed. Her