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February 1987

Ecthyma Gangrenosum Without Bacteremia: Report of Six Cases and Review of the Literature

Author Affiliations

From the Department of Internal Medicine "C," Beilinson Medical Center, Petah Tiqva, Israel (Drs Huminer, Morduchowicz, and Pitlik), and the Infectious Diseases Unit, Tel Aviv (Israel) Medical Center (Dr Siegman-Igra), Tel Aviv University Sackler School of Medicine.

Arch Intern Med. 1987;147(2):299-301. doi:10.1001/archinte.1987.00370020117047

• We encountered six patients with ecthyma gangrenosum due to Pseudomonas aeruginosa who, uncharacteristically, had no evidence of bacteremia prior to the institution of antibiotic therapy. Seven similar cases have previously been reported in the English-language medical literature. These 13 patients resembled those with classic ecthyma gangrenosum accompanied by Pseudomonas septicemia in being immunocompromised and neutropenic and having skin lesions at similar sites. The most striking difference between these two groups of patients was a significantly lower mortality rate for the nonbacteremic patients. These findings suggest that ecthyma gangrenosum can occur as a primary skin lesion in the absence of bacteremia. Patients with this particular subtype of infection appear to have a better prognosis than those having a preceding bacteremia.

(Arch Intern Med 1987;147:299-301)

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