Pseudomonas aeruginosa otochondritis complicating localized cutaneous leishmaniasis: prevention of mutilation by early antibiotic therapy.
A patient with an ulcerated cutaneous leishmaniasis of the pinna had suppurative otochondritis after a first unsuccessful course of treatment with meglumine antimoniate. Although the Leishmania ulceration healed after a second course of meglumine antimoniate, and despite three oral dicloxacillin or pristinamycin courses, the otochondritis extended and an abscess developed. Pus from the abscess revealed a pure culture of Pseudomonas aeruginosa. Five days of oral ciprofloxacin plus rifampin led to a marked improvement. The P. aeruginosa isolate was sensitive to ciprofloxacin but fully resistant to rifampin. Healing with minimal mutilation was obtained at the end of a six-week course of multiple antibiotic therapy. Pseudomonas aeruginosa otochondritis was a co-factor of cartilage mutilation in this patient. Thus, infection with P. aeruginosa should be promptly treated when present in tender cutaneous or mucosal leishmaniasis lesions near cartilaginous areas.
Van Der Vliet
Diane
D
Institut Pasteur Medical Center, Paris, France.
Le Guern
Anne-Sophie
AS
Freitag
Sylvie
S
Gounod
Nicolas
N
Therby
Audrey
A
Darie
Herve
H
Buffet
Pierre A
PA
D000328:Adult; D000818:Animals; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D000965:Antimony / Q000008:administration & dosage; D000981:Antiprotozoal Agents / Q000008:administration & dosage; D002356:Cartilage / Q000382:microbiology / Q000469:parasitology / Q000473:pathology; D002939:Ciprofloxacin / Q000627:therapeutic use*; D004431:Ear, External / Q000382:microbiology / Q000469:parasitology / Q000473:pathology; D006801:Humans; D007121:Immunocompetence; D016773:Leishmaniasis, Cutaneous / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008536:Meglumine / Q000008:administration & dosage; D000077485:Meglumine Antimoniate; D009942:Organometallic Compounds / Q000008:administration & dosage; D011552:Pseudomonas Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D012293:Rifampin / Q000627:therapeutic use*
D000890:Anti-Infective Agents; D000981:Antiprotozoal Agents; D009942:Organometallic Compounds; D002939:Ciprofloxacin; D008536:Meglumine; D000077485:Meglumine Antimoniate; D000965:Antimony; D012293:Rifampin