Son Young Min, Na So Young, Lee Hye Young, Baek Jin Ok, Lee Jong Rok, Roh Joo Young
Department of Dermatology, Gachon University of Medicine and Science, Gil Medical Center, Incheon, Korea.
Ann Dermatol. 2009 Nov;21(4):389-92. doi: 10.5021/ad.2009.21.4.389. Epub 2009 Nov 30.
Ecthyma gangrenosum (EG) is a well-recognized cutaneous infection that most commonly affects immunocompromised patients. It typically occurs on the extremities, or in gluteal and perineal regions. Although Pseudomonas aeruginosa is the most well-known pathogen causing EG, other organisms have been reported to cause EG. Herein we report a rare case of ecthyma gangrenosum presenting as aggressive necrotic skin lesions in perioral and infraorbital areas in a 47-year-old patient with acute myelocytic leukemia after allogeneic bone marrow transplantation. It was caused by Stenotrophomonas maltophilia, which is an aerobic, gram-negative pathogen that has been associated only rarely with cutaneous disease. Blood culture and tissue culture were positive for S. maltophilia. Histological examination revealed numerous tiny bacilli in the dermis and perivascular area. Early recognition of skin lesions caused by S. maltophilia is important to decrease associated mortality in immunosuppressed patients.
坏疽性脓皮病（EG）是一种公认的皮肤感染，最常影响免疫功能低下的患者。它通常发生在四肢，或臀部和会阴区域。虽然铜绿假单胞菌是引起EG最广为人知的病原体，但也有其他微生物被报道可导致EG。在此，我们报告一例罕见的坏疽性脓皮病病例，该病例表现为一名47岁急性髓细胞白血病患者在异基因骨髓移植后口周和眶下区域出现侵袭性坏死性皮肤病变。其病因是嗜麦芽窄食单胞菌，这是一种需氧的革兰氏阴性病原体，很少与皮肤疾病相关。血培养和组织培养显示嗜麦芽窄食单胞菌阳性。组织学检查显示真皮和血管周围区域有大量微小杆菌。早期识别嗜麦芽窄食单胞菌引起的皮肤病变对于降低免疫抑制患者的相关死亡率很重要。
