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January 1993

Invasive Pseudomonas Infection in Two Healthy Children Following Prolonged Bathing

Am J Dis Child. 1993;147(1):18-20. doi:10.1001/archpedi.1993.02160250020007

Sir.—Pseudomonas aeruginosa is a ubiquitous aerobic motile gram-negative rod that grows within a range of temperatures, in various environments like soil, sewage, and natural and tap water. It can infect almost all species of life from plants to invertebrates and vertebrates.1,2Pseudomonas aeruginosa produces a variety of toxins and enzymes that contribute to virulence and characteristic dermatologic manifestations of cellulitis, necrotizing subcutaneous nodules, and ecthyma gangrenosum. Natural opsonic and preformed antibodies and complement and phagocytic cells protect the healthy individual from invasion.3 There are multiple reports of self-limited Pseudomonas skin infection occurring in individuals after use of hot tubs, whirlpools, water slides, and swimming pools.4,5 Serious infections occur almost exclusively in debilitated individuals and in those with deficiencies of the immune system or white blood cell function. We describe two previously healthy children who developed life-threatening infections due to P aeruginosa, and propose that prolonged