Ecthyma gangrenosum and septic shock syndrome secondary to Chromobacterium violaceum

Herein, we report a case of a 68-year-old woman receiving ibrutinib for chronic lymphocytic leukaemia, who presented with septic shock and a progressive necrotic lesion on her nose. Surgical pathology of the nasal lesion revealed evidence of tissue necrosis, and both tissue and blood culture grew Pseudomonas aeruginosa. A diagnosis of ecthyma gangrenosum was made. Additional investigations also led to the discovery of invasive pulmonary aspergillosis. To our knowledge, this is the first case of ecthyma gangrenosum secondary to Pseudomonas sepsis and concurrent invasive pulmonary aspergillosis associated with ibrutinib use.

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1709: ECTHYMA GANGRENOSUM AND SEPTIC SHOCK AS PRECEDING SYMPTOMS OF ACUTE LEUKEMIA

Critical Care Medicine ◽

10.1097/01.ccm.0000510382.81814.19 ◽

2016 ◽

Vol 44 (12) ◽

pp. 502-502

Author(s):

Georgia Androutsopoulou ◽

Gloria Heresi ◽

Matthew Greives ◽

Konstantinos Boukas

Keyword(s):

Septic Shock ◽

Acute Leukemia ◽

Ecthyma Gangrenosum

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Chromobacterium violaceumIsolated from a Wound Sepsis: A Case Study from Nepal

Case Reports in Infectious Diseases ◽

10.1155/2015/181946 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

Shamshul Ansari ◽

Pramod Paudel ◽

Kishor Gautam ◽

Sony Shrestha ◽

Sangita Thapa ◽

...

Keyword(s):

Septic Shock ◽

Mortality Rate ◽

Multiorgan Failure ◽

Middle Finger ◽

Chromobacterium Violaceum ◽

Causative Organism ◽

Wound Sepsis ◽

First Case ◽

Systemic Infections

Chromobacterium violaceumis a facultative anaerobic, Gram-negative rod, prevalent in tropical and subtropical regions. It enters through the skin injury and is capable of causing severe systemic infections leading to septic shock and multiorgan failure. It has been reported by few authors across the world but this is probably the first case ofChromobacterium violaceumisolated from wound sepsis from Nepal. In this study, a pus sample from the infection of a prick injury in the left middle finger was collected from the patient admitted to the intensive care unit. Bacteriological investigations of the pus sample revealed the causative organism to beChromobacterium violaceum. This case study indicates thatChromobacterium violaceumcan act as a potential cause of wound sepsis that may lead to the septic shock and if not treated timely, the mortality rate can be high as was in this study. Although this organism is very rare, the infection caused requires prompt treatment to minimize the mortality rate. Therefore, we recommend the timely diagnosis and antimicrobial therapy of this infection to combat the consequences led.

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1785: CHROMOBACTERIUM VIOLACEUM SEPTIC SHOCK IN A HEALTHY TEENAGER

Critical Care Medicine ◽

10.1097/01.ccm.0000510458.97707.02 ◽

2016 ◽

Vol 44 (12) ◽

pp. 521-521

Author(s):

Laura Wright-Sexton ◽

April Palmer ◽

Kenneth Muldrew ◽

Steven Bondi

Keyword(s):

Septic Shock ◽

Chromobacterium Violaceum

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Ecthyma gangrenosum in a patient with febrile pancytopenia

Our Dermatology Online ◽

10.7241/ourd.20221.24 ◽

2022 ◽

Vol 13 (1) ◽

pp. 98-98

Author(s):

Samia Mrabat ◽

Hanane Baybay ◽

Ryme Dassouly ◽

Zakia Douhi ◽

Sara Elloudi ◽

...

Keyword(s):

Septic Shock ◽

Plasma Cells ◽

Maculopapular Rash ◽

Severe Thrombocytopenia ◽

Immunocompromised Patients ◽

Cutaneous Infection ◽

Left Flank ◽

Ecthyma Gangrenosum ◽

Dermatological Examination ◽

Hemorrhagic Bullae

Ecthyma gangrenosum (EG) is a cutaneous infection most commonly associated with Pseudomonas bacteremia and usually occurring in immunocompromised patients [1]. The infection progresses sequentially from a maculopapular rash to hemorrhagic bullae, then to necrotic ulcerations with surrounding erythema [2]. Herein, we report a case of ecthyma gangrenosum in an immunologically compromised patient. A 65-year-old female was admitted to the oncohematology department for febrile pancytopenia. Blood work revealed severe thrombocytopenia at 15,000/mm³), an absolute neutrophil count of 180 cells/mm³, and anemia. A sternal bone marrow puncture found 15% of plasma cells. Four days after the admission, the patient had a painful, quickly extending lesion on the abdomen. She described erythema that progressed to pustules, then ulcerations. On general clinical evaluation, the patient was feverish at 40°C. A dermatological examination revealed the presence of a 6 cm purpuric patch on the left flank with a central necrotic eschar (Fig. 1). The diagnosis of ecthyma gangrenosum was reached and the patient was treated with ceftazidime and vancomycin. Unfortunately, having gone into septic shock, the patient died one week later.

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Review on Chromobacterium violaceum, a Rare but Fatal Bacteria Needs Special Clinical Attention

Anwer Khan Modern Medical College Journal ◽

10.3329/akmmcj.v10i2.44131 ◽

2019 ◽

Vol 10 (2) ◽

pp. 169-175

Author(s):

Sadia Sharmin ◽

SM Mostofa Kamal

Keyword(s):

Septic Shock ◽

High Frequency ◽

Distress Syndrome ◽

Opportunistic Pathogen ◽

Chromobacterium Violaceum ◽

Gram Negative ◽

Medical College ◽

Tract Infections ◽

Prompt Diagnosis ◽

Soil And Water

Chromobacterium violaceum is isolated from soil and water in tropical and subtropical areas. This Gram negative, capsulated, motile bacillus is considered as a saprophyte but occasionally it can act as an opportunistic pathogen for animals and human. It causes skin lesion with liver and lung abscesses, pneumonia, gastrointestinal tract infections, urinary tract infections, osteomyelitis, meningitis, peritonitis, endocarditis, respiratory distress syndrome and septic shock. Increasing reported cases with Chrombacterium violaceum infection has been noticed in recent decades. It should be considered for its difficult-to-treat entity characterized by a high frequency of sepsis, distantant metastasis, multidrug resistance and relapse. High mortality rate associated with this infection necessitate prompt diagnosis and appropriate antimicrobial therapy Anwer Khan Modern Medical College Journal Vol. 10, No. 2: July 2019, P 169-175

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Fatal septicemia caused by Chromobacterium violaceum in a child from Colombia

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652007000600011 ◽

2007 ◽

Vol 49 (6) ◽

pp. 391-393 ◽

Cited By ~ 5

Author(s):

Pedro Martinez ◽

Salim Mattar

Keyword(s):

Septic Shock ◽

Abdominal Pain ◽

Multiple Organ Failure ◽

Organ Failure ◽

Multiple Organ ◽

Blood Cultures ◽

Severe Abdominal Pain ◽

Chromobacterium Violaceum ◽

History Of ◽

Fatal Septicemia

A 4-year old child living in Colombia presented with a history of fever and severe abdominal pain for four days. The patient developed pneumonia, septic shock, multiple organ failure and died on the fifth day of hospitalization. Chromobacterium violaceum was isolated from admission blood cultures and was resistant to ampicillin, cephalosporins, carbapenems and aminoglycosides.

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Pseudomonas aeruginosa septic shock associated with ecthyma gangrenosum in an infant with agammaglobulinemia

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652002000300010 ◽

2002 ◽

Vol 44 (3) ◽

pp. 167-169 ◽

Cited By ~ 11

Author(s):

João Fernando Lourenço de ALMEIDA ◽

Jaques SZTAJNBOK ◽

Eduardo Juan TROSTER ◽

Flávio Adolfo Costa VAZ

Keyword(s):

Septic Shock ◽

Pseudomonas Aeruginosa ◽

Intravenous Immunoglobulin ◽

Invasive Infection ◽

Ecthyma Gangrenosum ◽

Antibiotic Coverage

Ecthyma gangrenosum (EG) due to Pseudomonas aeruginosa is a rare and invasive infection that can be associated with agammaglobulinemia. The cornerstone of the treatment is based on prompt recognition with appropriate antibiotic coverage and intravenous immunoglobulin. The authors report a case of EG emphasizing the clinical and therapeutic aspects of this condition.

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