title: Colostomy for Perianal Sepsis With Ecthyma Gangrenosum in Immunocompromised Children.
abstract: BACKGROUND
  Perianal sepsis with ecthyma gangrenosum is a severe and potentially mutilating complication in immunocompromised children. Therapies include antimicrobial treatment, incision and drainage, generous tissue debridement, and skin transplantation.
  
  
  METHODS
  We describe 3 children with acute lymphoblastic leukemia having sepsis with Pseudomonas aeruginosa in febrile neutropenia and severe perianal infections treated relatively early with a protective colostomy. Indications for colostomy were nonhealing wounds, and ceaseless pain.
  
  
  RESULTS
  All patients showed a rapid reduction of pain. Complete wound healing was seen in 2 patients, and considerable pain reduction and increased quality of life were seen in a third patient during palliative care.
  
  
  CONCLUSIONS
  These results suggest that a protective colostomy should be considered early in the management of immunocompromised children with ecthyma gangrenosum.
authors.affiliation: *Department of Pediatric Surgery ‡Division of Infectious Diseases and Hospital Epidemiology §Division of Oncology †Children's Research Centre, University Children's Hospital of Zurich, Zurich, Switzerland.
authors.forename: Raphael N
authors.initials: RN
authors.lastname: Vuille-dit-Bille
authors.forename: Christoph
authors.initials: C
authors.lastname: Berger
authors.forename: Martin
authors.initials: M
authors.lastname: Meuli
authors.forename: Michael A
authors.initials: MA
authors.lastname: Grotzer
mesh_terms: D001003:Anal Canal / Q000473:pathology*; D002675:Child, Preschool; D003125:Colostomy / Q000379:methods*; D004473:Ecthyma / Q000276:immunology / Q000601:surgery; D064147:Febrile Neutropenia / Q000209:etiology; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications*; D011552:Pseudomonas Infections / Q000276:immunology; D018805:Sepsis / Q000276:immunology / Q000601:surgery*