title: GM-CSF contributes to prompt healing of ecthyma gangrenosum lesions in kidney transplant recipient.
abstract: BACKGROUND
  Ecthyma gangrenosum (EG) is an unusual, potentially fatal cutaneous disease, commonly associated with Pseudomonas aeruginosa septicemia.
  
  
  METHODS
  We report the case of a 61-year-old man admitted to the Nephrology Department for fever, leukopenia and inguinal and scrotal painful lesions. Physical examination revealed inguinal and scrotal macules, nodules, blisters and ulcers with central necrosis. P. aeruginosa was isolated from an ulcer. EG was diagnosed. Because of the severe leukopenia, granulocyte-macrophage colony-stimulating factor (GM-CSF) was administered until the white blood cell count significantly increased. Based on antibiogram, intravenous ceftazidime and teicoplanin were given for 11 days. Cutaneous manifestations were completely healed in about 2 months.
  
  
  CONCLUSIONS
  We suggest that the combination of GM-CSF with appropriate antibiotics can resolve EG and avoid or minimize the risk of septicemia in immunosuppressed patients.
authors.affiliation: Nephrology, Dialysis and Transplantation Unit, IRCCS Foundation and University Hospital San Matteo, Pavia, Italy. m.gregorini@smatteo.pv.it
authors.forename: Marilena
authors.initials: M
authors.lastname: Gregorini
authors.forename: Michela
authors.initials: M
authors.lastname: Castello
authors.forename: Teresa
authors.initials: T
authors.lastname: Rampino
authors.forename: Francesca
authors.initials: F
authors.lastname: Bosio
authors.forename: Giulia
authors.initials: G
authors.lastname: Bedino
authors.forename: Pasquale
authors.initials: P
authors.lastname: Esposito
authors.forename: Giovanni
authors.initials: G
authors.lastname: Borroni
authors.forename: Antonio
authors.initials: A
authors.lastname: Dal Canton
mesh_terms: D004473:Ecthyma / Q000188:drug therapy* / Q000382:microbiology; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000188:drug therapy*; D011550:Pseudomonas aeruginosa
chemical_list: D016178:Granulocyte-Macrophage Colony-Stimulating Factor