title: Ecthyma gangrenosum: A manifestation of community-acquired Pseudomonas aeruginosa septicemia in three infants.
abstract: OBJECTIVE
  Pseudomonas aeruginosa sepsis usually carries a high mortality rate in immunocompromised children. Ecthyma gangrenosum is a known cutaneous manifestation due mainly to Pseudomonas infection with or without septicemia. We describe clinical, biological, and therapeutic data.
  
  
  METHODS
  Of those children admitted to the pediatric intensive care unit, three pediatric cases of community-acquired P. aeruginosa septicemia associated with ecthyma gangrenosum were retrospectively reviewed.
  
  
  RESULTS
  The three patients were aged 5 months, 9 months, and 1 year. Underlying hypogammaglobulinemia was detected in the oldest patient. Pseudomonas aeruginosa was isolated in all patients in blood and once in cultures of skin lesions and endotracheal aspirate. Two deaths occurred due to septic shock and multisystem organ failure despite numerous aggressive resuscitation attempts.
  
  
  CONCLUSIONS
  P. aeruginosa sepsis should be treated as early as possible. Recognition of ecthyma gangrenosum allows early diagnosis and prescription of adequate antibiotic therapy without awaiting blood culture reports.
authors.affiliation: Department of pediatrics, pediatric emergency and intensive care, Hedi Chaker Hospital, route El Aïn, 3029 Sfax, Tunisia; Faculty of Medecine, Sfax, Tunisia. Electronic address: abdelhedigargourilamia@yahoo.fr.
authors.forename: L
authors.initials: L
authors.lastname: Gargouri
authors.affiliation: Faculty of Medecine, Sfax, Tunisia; Pediatric department, Hedi Chaker Hospital, Sfax, Tunisia.
authors.forename: I
authors.initials: I
authors.lastname: Maaloul
authors.affiliation: Faculty of Medecine, Sfax, Tunisia; Pediatric department, Hedi Chaker Hospital, Sfax, Tunisia.
authors.forename: T
authors.initials: T
authors.lastname: Kamoun
authors.affiliation: Department of pediatrics, pediatric emergency and intensive care, Hedi Chaker Hospital, route El Aïn, 3029 Sfax, Tunisia; Faculty of Medecine, Sfax, Tunisia.
authors.forename: B
authors.initials: B
authors.lastname: Maalej
authors.affiliation: Department of pediatrics, pediatric emergency and intensive care, Hedi Chaker Hospital, route El Aïn, 3029 Sfax, Tunisia; Faculty of Medecine, Sfax, Tunisia.
authors.forename: F
authors.initials: F
authors.lastname: Safi
authors.affiliation: Department of pediatrics, pediatric emergency and intensive care, Hedi Chaker Hospital, route El Aïn, 3029 Sfax, Tunisia; Faculty of Medecine, Sfax, Tunisia.
authors.forename: I
authors.initials: I
authors.lastname: Majdoub
authors.affiliation: Faculty of Medecine, Sfax, Tunisia; Pediatric department, Hedi Chaker Hospital, Sfax, Tunisia.
authors.forename: M
authors.initials: M
authors.lastname: Hachicha
authors.affiliation: Department of pediatrics, pediatric emergency and intensive care, Hedi Chaker Hospital, route El Aïn, 3029 Sfax, Tunisia; Faculty of Medecine, Sfax, Tunisia.
authors.forename: A
authors.initials: A
authors.lastname: Mahfoudh
mesh_terms: D017714:Community-Acquired Infections / Q000150:complications; D004473:Ecthyma / Q000209:etiology* / Q000473:pathology; D005260:Female; D005734:Gangrene; D006801:Humans; D007223:Infant; D008297:Male; D011552:Pseudomonas Infections / Q000150:complications*; D011550:Pseudomonas aeruginosa; D012189:Retrospective Studies; D018805:Sepsis / Q000150:complications* / Q000382:microbiology