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16 September 2019 : Case report  USA

Ecthyma Gangrenosum of Scrotum in a Patient with Neutropenic Fever: A Case Report

Challenging differential diagnosis, Management of emergency care, Rare coexistence of disease or pathology

Jose A. Rodriguez1BEF, Paula A. Eckardt2ADE*, Juan C. Lemos-Ramirez2DE, Jianli Niu3EF

DOI: 10.12659/AJCR.917443

Am J Case Rep 2019; 20:1369-1372

Abstract

BACKGROUND: Ecthyma gangrenosum is an uncommon cutaneous infection commonly caused by Pseudomonas aeruginosa affecting typically immunocompromised patients. The presence of ecthyma gangrenosum can be associated with severe systemic infection often with a fatal prognosis. Most cases of ecthyma gangrenosum occur around the axilla, buttocks, and limbs; the scrotum is rarely affected.

CASE REPORT: A 68-year-old male with previously diagnosed acute myeloid leukemia, presented with left scrotal pain, fever, and rigors. Physical examination showed 2 ulcerating lesions with central black eschars surrounded by erythematous halos on the superior aspect of the left scrotum. Diagnosis of ecthyma gangrenosum was confirmed as both blood and lesion cultures showed growth of P. aeruginosa. After early empiric antibiotic treatment, the lesions significantly improved, and no sign of recurrence or new lesions was noticed.

CONCLUSIONS: Ecthyma gangrenosum should be considered in the differential diagnosis of ulcerating lesions of the scrotum. An early diagnosis and aggressive antibiotic treatment are imperative for resolution of this infection.

Keywords: Ecthyma, febrile neutropenia, Leukemia, Myeloid, Acute, Pseudomonas aeruginosa, Scrotum, Aged, Immunocompromised Host, Pseudomonas Infections

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923