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坏疽性脓皮病，一名既往健康儿童铜绿假单胞菌败血症的皮肤表现：病例报告

Ecthyma gangrenosum, a skin manifestation of Pseudomonas aeruginosa sepsis in a previously healthy child: A case report.

作者信息

Biscaye Stephanie, Demonchy Diane, Afanetti Mickael, Dupont Audrey, Haas Herve, Tran Antoine

机构信息

Pediatric Hospitals of Nice CHU-Lenval, Nice, France.

出版信息

Medicine (Baltimore). 2017 Jan;96(2):e5507. doi: 10.1097/MD.0000000000005507.

DOI:10.1097/MD.0000000000005507
PMID:28079790
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5266152/
Abstract

RATIONALE

Ecthyma gangrenosum (Eg) is a necrotic lesion that is mostly seen in immunocompromised patients. It reflects a severe sepsis, possibly caused by Pseudomonas aeruginosa (Pa).

PATIENT CONCERNS

A healthy 3-year-old girl admitted to the Pediatric Emergency Department presented a sepsis-associated purpura with neurological and respiratory distress.

INTERVENTIONS

An empiric antibiotherapy (anti-meningococcal) was prescribed.

DIAGNOSES

Forty-eight hours after admission, blood and wound cultures were positive for Pa. As a result, the decision was made to change the antibiotic therapy.Unfortunately, on day 3, the patient died. Exhaustive immunologic tests are presently being carried out.

OUTCOMES

Eg caused by Pa is uncommon in healthy children, and purpura sepsis is usually caused by Neisseria meningitides infection.

LESSONS

Eg should be recognized rapidly so that the appropriate treatment can be prescribed as quickly as possible.

摘要

理论依据

坏疽性脓皮病（Eg）是一种坏死性病变，多见于免疫功能低下的患者。它反映了一种严重的脓毒症，可能由铜绿假单胞菌（Pa）引起。

患者情况

一名3岁健康女童因出现与脓毒症相关的紫癜并伴有神经和呼吸窘迫症状被送往儿科急诊科。

干预措施

给予经验性抗生素治疗（抗脑膜炎球菌）。

诊断结果

入院48小时后，血液和伤口培养物检测显示Pa呈阳性。因此，决定更改抗生素治疗方案。不幸的是，第3天患者死亡。目前正在进行全面的免疫学检查。

结果

由Pa引起的Eg在健康儿童中并不常见，紫癜性脓毒症通常由脑膜炎奈瑟菌感染引起。

经验教训

应迅速识别Eg，以便尽快开出适当的治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e91e/5266152/2ec675f2c543/medi-96-e5507-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e91e/5266152/373e0dd46ec5/medi-96-e5507-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e91e/5266152/a0a285133fe0/medi-96-e5507-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e91e/5266152/7a223ed65b13/medi-96-e5507-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e91e/5266152/2ec675f2c543/medi-96-e5507-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e91e/5266152/373e0dd46ec5/medi-96-e5507-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e91e/5266152/a0a285133fe0/medi-96-e5507-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e91e/5266152/7a223ed65b13/medi-96-e5507-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e91e/5266152/2ec675f2c543/medi-96-e5507-g004.jpg

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