Ecthyma Gangrenosum about a Case at the Centre Hospitalier Roi Baudoin de Guédiawaye in Senegal

Abstract

Background and Aim: Ecthyma gangrenosum (EG) is a rare necrotic skin infection caused by Pseudomonas aeruginosa occurring on healthy skin main-ly, but not exclusively, in immunocompromised patients. We report the case of EG of unusual presentation in a 12-month-old infant. Case Presentation: This was a 12-month-old male infant who was referred from a peripheral structure for the treatment of facial swelling associated with fever. In his ante-natal and intra nasal history, there was a notion of hospitalization for 15 days for early neonatal infection and a delay in psychomotor development. The admission examination showed the fair general condition, hyperthermia at 39˚C, tachycardia at 136 beats/minute, and polypnea at 48 cycles/minute. The weight-for-height index with a z-score of 3DS was also found. The dermatological examination at the entrance found an extensive brownish inflammatory tense infiltrated plaque taking the mandibular, submental, retro-auricular occipital regions rapidly evolving towards necrosis, a significant swelling predominant on the upper right eyelid preventing the opening of the associated eyes to mouth ulcera-tion. Biological abnormalities were predominantly neutrophilic leukocytosis, elevated CRP, and elevated muscle enzymes. Microbiological examination of skin samples had isolated Pseudomonas aeruginosa. He had received antibiotic therapy, and a necrosectomy under general anesthesia. The evolution was favorable and he was discharged from the hospital on D26 of hospitalization. Conclusion: This observation is rare due to its location, its early onset, and non-neutropenic background.