The significance of ecthyma gangrenosum in early diagnosis of pseudomonas aeruginosa sepsis in chidren

Abstract

Objective To summarize the characteristics of ecthyma gangrenosum and explore its significance in early diagnosis of pseudomonas aeruginosa sepsis in children.Methods We retrospectively reviewed the medical records of 11 children with ecthyma gangrenosum who were hospitalized at Guangzhou women and children's medical center between May 2008 and Apr 2011.Results Eight cases were male and 7 were less than twelve months,the oldest was 2 years old,all of them were diagnosed as Pseudomonas aeruginosa spesis.Two patients had a single lesion,and the others had multiple lesions.Ecthyma gangrenosum located on the trunks in 7 cases,on anogenital areas in 5 cases,on extremities in 5 cases and on faces in 3.The lesions appeared on day 2 to day 10.On average,they developed on day 5.Seven patients developed ecthyma gangrenosum before admission,the course of the illness before admission was 6 days.Fever and multiple organ dysfunction occurred in all the patients and their cultures grew pseudomonas aeruginosa,blood cultures were positive in 8 cases,the others were isolated psudomonas aeruginosa from tissue of the lesion,discharge,ascites,pleural effusion,respectively.The time of ecthyma gangrenosum appeared was earlier than the time of the culture results reported.All of the patients were started empiric antibiotics therapy on admission,the initial antibiotic regimen was appropriate in 9 patients,8 needed surgical intervention,4 were treated with continuous blood purification.Ten patients survived and 2 died,the hospital stay was from 1 to 63 days,the average was 30.Conclusion Ecthyma gangrenosum is a known cutaneous manifestation of pseudomonas aeruginosa sepsis,which is helpful for early diagnosis and treatment,and then the outcome will be improved. Key words: Ecthyma gangrenosum ; Pseudomonas aeruginosa; Sepsis; Children