TITLE:
Ecthyma Gangrenosum about a Case at the Centre Hospitalier Roi Baudoin de Guédiawaye in Senegal
AUTHORS:
Jean Baptiste Niokhor Diouf, Hadja Mariama Barry, Louis Philippe Sarr, Ndèye Diama Ba
KEYWORDS:
Ecthyma Gangrenosum, Pseudomonas aeruginosa, Infant
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.12 No.4,
September
1,
2022
ABSTRACT: Background and Aim: Ecthyma gangrenosum (EG) is a rare necrotic skin infection caused by Pseudomonas
aeruginosa occurring on healthy skin mainly, but not exclusively, in
immunocompromised patients. We report the case of EG of unusual
presentation in a 12-month-old infant. Case Presentation: This was a 12-month-old male infant who was
referred from a peripheral structure
for the treatment of facial swelling associated with fever.
In his antenatal and intra nasal history, there was a notion of hospitalization for 15 days for
early neonatal infection and a delay in psychomotor development. The admission
examination showed the fair general condition, hyperthermia at 39°C,
tachycardia at 136 beats/minute, and polypnea at 48 cycles/minute. The
weight-for-height index with a z-score of 3DS was also found. The
dermatological examination at the entrance
found an extensive brownish inflammatory tense infiltrated plaque taking the mandibular, submental,
retro-auricular occipital regions rapidly evolving towards necrosis, a
significant swelling predominant on the upper right eyelid preventing the
opening of the associated eyes to mouth ulceration. Biological abnormalities
were predominantly neutrophilic leukocytosis, elevated CRP, and elevated
muscle enzymes. Microbiological examination of skin samples had isolated Pseudomonas aeruginosa. He had received
antibiotic therapy, and a necrosectomy under general anesthesia. The evolution was favorable and
he was discharged from the hospital on D26 of hospitalization. Conclusion: This observation
is rare due to its location, its early onset, and non-neutropenic background.