title: Pseudomonas aeruginosa ecthyma gangrenosum in a woman with recurrent Graves' disease.
abstract: A 35-year-old woman with postoperative recurrent Graves' disease presented with a 5-day history of a red swelling on the right cheek associated with 4 days of remittent hyperpyrexia. Investigations revealed fever, a gangrenous ulcer on the right cheek, submandibular lymphadenopathy, and thyroid gland enlargement. Her white blood cell count, immunoglobulins, and lymphocyte subsets were unremarkable. Thyroid function tests showed low thyroid-stimulating hormone, high free thyroxine, and elevated radioactive iodine uptake. Repeated pus cultures grew Pseudomonas aeruginosa, but blood cultures were negative. An ill-demarcated erythematous plaque occurred on the right leg on hospital day 3. She was treated with intravenous antibiotics with topical gentamicin, recombinant bovine basic fibroblast growth factor, and radioiodine therapy with anti-thyroid drugs. The ulcer healed leaving a depressed scar at 35 days after discharge. This patient may represent the first case of P. aeruginosa ecthyma gangrenosum and cellulitis in postoperative recurrent Graves' disease.
authors.affiliation: Department of Dermatology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong 524001, China.
authors.forename: Cheng-Yao
authors.initials: CY
authors.lastname: Zhu
authors.affiliation: Department of Dermatology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong 524001, China.
authors.forename: Guo-Xue
authors.initials: GX
authors.lastname: Zhang
authors.affiliation: Department of Dermatology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong 524001, China.
authors.forename: Zuo-Zhong
authors.initials: ZZ
authors.lastname: Yu
authors.affiliation: Department of Dermatology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong 524001, China.
authors.forename: Zhao-Jun
authors.initials: ZJ
authors.lastname: Li
authors.affiliation: Department of Dermatology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong 524001, China. Electronic address: ymfan1963@163.com.
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Fan
mesh_terms: D000328:Adult; D002481:Cellulitis / Q000150:complications* / Q000378:metabolism / Q000382:microbiology / Q000473:pathology; D004473:Ecthyma / Q000150:complications* / Q000378:metabolism / Q000382:microbiology / Q000473:pathology; D005260:Female; D006111:Graves Disease / Q000150:complications* / Q000378:metabolism / Q000382:microbiology / Q000473:pathology; D006801:Humans; D011552:Pseudomonas Infections / Q000150:complications* / Q000378:metabolism / Q000382:microbiology / Q000473:pathology; D011550:Pseudomonas aeruginosa / Q000472:pathogenicity / Q000502:physiology; D012008:Recurrence
keywords: Cellulitis; Ecthyma gangrenosum; Graves’ disease; Pseudomonas aeruginosa