Ecthyma gangrenosum: A case report in a child with acute lymphoblastic leukaemia
Aim: We present a case of Ecthyma gangrenosum (EG) affecting left thigh in a child with acute lymphoblastic leukaemia (ALL) with an aim to raise awareness about this condition. Case presentation: A 7-year-old female child who presented with lethargy, pallor and lumps to inner lip was diagnosed with...
| Principais autores: | , , , , , |
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| Formato: | Artigo |
| Idioma: | English |
| Publicado em: |
Elsevier
2024-06-01
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| coleção: | JPRAS Open |
| Assuntos: | |
| Acesso em linha: | http://www.sciencedirect.com/science/article/pii/S2352587824000275 |
| _version_ | 1827242553160761344 |
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| author | I Yonjan Lama LK Cheung A James M Saghir F Herd J Greenhowe |
| author_facet | I Yonjan Lama LK Cheung A James M Saghir F Herd J Greenhowe |
| author_sort | I Yonjan Lama |
| collection | DOAJ |
| description | Aim: We present a case of Ecthyma gangrenosum (EG) affecting left thigh in a child with acute lymphoblastic leukaemia (ALL) with an aim to raise awareness about this condition. Case presentation: A 7-year-old female child who presented with lethargy, pallor and lumps to inner lip was diagnosed with B-cell precursor ALL. She was started on treatment as per UKALL 2011 guidelines Regime B. On day 28, she developed neutropenic sepsis along with a new lesion in her left thigh. She was started on intravenous Meropenum, Gentamicin and Caspofungin. The clinical diagnosis of EG was made based on lesion progression, positive blood and wound swab & tissue cultures for Pseudomonas aeruginosa and patient's immunocompromised status. The wound healed with secondary intention following debridement. We present a series of photographs to demonstrate her remarkable improvement. Discussion: EG occurs in 1–30% of cases of Pseudomonas sepsis; other bacteria and fungi can be associated with this condition. It is identified more in oncology patients as seen in our patient. A multidisciplinary team approach should be provided in 3 stages with empirical antibiotics, followed by targeted antibiotics or antifungals & surgical debridement. Our patient was treated in similar fashion and made a good recovery. Conclusion: It is a rare skin condition associated with a high mortality. We suggest all clinicians to be vigilant about this condition to be able to provide accurate diagnosis and prompt treatment to improve the overall prognosis. |
| first_indexed | 2024-04-24T07:37:07Z |
| format | Article |
| id | doaj.art-2786987815f24866a47feef9b80dfa5b |
| institution | Directory Open Access Journal |
| issn | 2352-5878 |
| language | English |
| last_indexed | 2025-03-21T21:58:12Z |
| publishDate | 2024-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JPRAS Open |
| spelling | doaj.art-2786987815f24866a47feef9b80dfa5b2024-05-26T04:36:38ZengElsevierJPRAS Open2352-58782024-06-0140215221Ecthyma gangrenosum: A case report in a child with acute lymphoblastic leukaemiaI Yonjan Lama0LK Cheung1A James2M Saghir3F Herd4J Greenhowe5Royal Aberdeen Children's Hospital, Department of Plastic Surgery, Aberdeen, Scotland, UK; Corresponding author.Guy's and St Thomas' NHS Foundation Trust, London, England, UKAberdeen Royal Infirmary, Department of Plastic surgery, Aberdeen, Scotland, UKAberdeen Royal Infirmary, Department of Plastic surgery, Aberdeen, Scotland, UKRoyal Aberdeen Children's Hospital, Department of Oncology, Aberdeen, Scotland, UKRoyal Aberdeen Children's Hospital, Department of Plastic Surgery, Aberdeen, Scotland, UKAim: We present a case of Ecthyma gangrenosum (EG) affecting left thigh in a child with acute lymphoblastic leukaemia (ALL) with an aim to raise awareness about this condition. Case presentation: A 7-year-old female child who presented with lethargy, pallor and lumps to inner lip was diagnosed with B-cell precursor ALL. She was started on treatment as per UKALL 2011 guidelines Regime B. On day 28, she developed neutropenic sepsis along with a new lesion in her left thigh. She was started on intravenous Meropenum, Gentamicin and Caspofungin. The clinical diagnosis of EG was made based on lesion progression, positive blood and wound swab & tissue cultures for Pseudomonas aeruginosa and patient's immunocompromised status. The wound healed with secondary intention following debridement. We present a series of photographs to demonstrate her remarkable improvement. Discussion: EG occurs in 1–30% of cases of Pseudomonas sepsis; other bacteria and fungi can be associated with this condition. It is identified more in oncology patients as seen in our patient. A multidisciplinary team approach should be provided in 3 stages with empirical antibiotics, followed by targeted antibiotics or antifungals & surgical debridement. Our patient was treated in similar fashion and made a good recovery. Conclusion: It is a rare skin condition associated with a high mortality. We suggest all clinicians to be vigilant about this condition to be able to provide accurate diagnosis and prompt treatment to improve the overall prognosis.http://www.sciencedirect.com/science/article/pii/S2352587824000275Ecthyma gangrenosumLeukaemiaNeutropeniaPaediatricsPseudomonas aeruginosa |
| spellingShingle | I Yonjan Lama LK Cheung A James M Saghir F Herd J Greenhowe Ecthyma gangrenosum: A case report in a child with acute lymphoblastic leukaemia JPRAS Open Ecthyma gangrenosum Leukaemia Neutropenia Paediatrics Pseudomonas aeruginosa |
| title | Ecthyma gangrenosum: A case report in a child with acute lymphoblastic leukaemia |
| title_full | Ecthyma gangrenosum: A case report in a child with acute lymphoblastic leukaemia |
| title_fullStr | Ecthyma gangrenosum: A case report in a child with acute lymphoblastic leukaemia |
| title_full_unstemmed | Ecthyma gangrenosum: A case report in a child with acute lymphoblastic leukaemia |
| title_short | Ecthyma gangrenosum: A case report in a child with acute lymphoblastic leukaemia |
| title_sort | ecthyma gangrenosum a case report in a child with acute lymphoblastic leukaemia |
| topic | Ecthyma gangrenosum Leukaemia Neutropenia Paediatrics Pseudomonas aeruginosa |
| url | http://www.sciencedirect.com/science/article/pii/S2352587824000275 |
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