title: Pseudomonas aeruginosa otochondritis complicating localized cutaneous leishmaniasis: prevention of mutilation by early antibiotic therapy.
abstract: 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.
authors.affiliation: Institut Pasteur Medical Center, Paris, France.
authors.forename: Diane
authors.initials: D
authors.lastname: Van Der Vliet
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Le Guern
authors.forename: Sylvie
authors.initials: S
authors.lastname: Freitag
authors.forename: Nicolas
authors.initials: N
authors.lastname: Gounod
authors.forename: Audrey
authors.initials: A
authors.lastname: Therby
authors.forename: Herve
authors.initials: H
authors.lastname: Darie
authors.forename: Pierre A
authors.initials: PA
authors.lastname: Buffet
mesh_terms: 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*
chemical_list: D000890:Anti-Infective Agents; D000981:Antiprotozoal Agents; D009942:Organometallic Compounds; D002939:Ciprofloxacin; D008536:Meglumine; D000077485:Meglumine Antimoniate; D000965:Antimony; D012293:Rifampin