Versapuech J, Léauté-Labrèze C, Thedenat B, Taieb A, Ragnaud J M
Service de dermatologie, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux, France.
Rev Med Interne. 2001 Sep;22(9):877-80. doi: 10.1016/s0248-8663(01)00439-8.
Ecthyma gangrenosum is a rare skin infection caused by gram negative bacteria. It involves immunocompromised patients, especially neutropenic patients, and can be easily diagnosed.
We report a case of ecthyma gangrenosum without septicemia due to Pseudomonas aeruginosa in a myelodysplastic patient with severe neutropenia. Granulocyte growth factors adjunction was necessary in combination to antibiotics to obtain complete healing.
In neutropenic patient, ecthyma gangrenosum due to Pseudomonas aeruginosa should be rapidly diagnosed to avoid septicemic complications. In the case of antibiotic treatment failure, granulocyte growth factors may be added. Frequent Pseudomonas aeruginosa infections justify bacteriologic survey to look for hospital contamination.
坏疽性脓皮病是一种由革兰氏阴性菌引起的罕见皮肤感染。它多见于免疫功能低下的患者，尤其是中性粒细胞减少的患者，且易于诊断。
我们报告了一例骨髓增生异常且伴有严重中性粒细胞减少的患者发生的由铜绿假单胞菌引起的无败血症的坏疽性脓皮病病例。联合使用粒细胞生长因子和抗生素是实现完全愈合所必需的。
对于中性粒细胞减少的患者，应迅速诊断由铜绿假单胞菌引起的坏疽性脓皮病，以避免败血症并发症。若抗生素治疗失败，可加用粒细胞生长因子。铜绿假单胞菌感染频发，因此有必要进行细菌学调查以查找医院感染源。
