Ecthyma gangrenosum of the scrotum: a case report

Abstract

A 43-year-old man with pancytopenia from chemotherapy for acute myeloid leukemia developed left scrotal pain, fever, and rigors. Physical exam revealed an ulcerating lesion with central necrosis and eschar surrounded by a halo of erythema on the inferior aspect of the left scrotum. The condition indicated an early necrotizing soft tissue infection. The patient was started on broad-spectrum antibiotics and taken to the operating room for a wound debridement. Blood and tissue cultures grew Pseudomonas aeruginosa, which confirmed the diagnosis of ecthyma gangrenosum of the scrotum. The fever resolved, and the wound healed without further progression after wet to dry dressing changes.

Keywords

ecthyma gangrenosum / scrotum / genitalia

References

[1] Barker LF. The clinical symptoms, bacteriologic findings and postmortem appearances in cases of infection of human beings with the Bacillus pyocyaneus. JAMA 1897; 29(5): 213–216

[2] Vaiman M, Lazarovitch T, Heller L, Lotan G. Ecthyma gangrenosum and ecthyma-like lesions: review article. Eur J Clin Microbiol Infect Dis 2015; 34(4): 633–639

[3] Soria A, Francès C, Guihot A, Varnous S, Bricaire F, Caumes E. Etiology of ecthyma gangrenosum: four cases. Ann Dermatol Venereol 2010; 137(6-7): 472–476 (in French)

[4] Edelstein H, Cutting HO. Escherichia coli as cause of ecthyma gangrenosum. Postgrad Med 1986; 79(2): 44–45

[5] Zomorrodi A, Wald ER. Ecthyma gangrenosum: considerations in a previously healthy child. Pediatr Infect Dis J 2002; 21(12): 1161–1164

[6] Koo SH, Lee JH, Shin H, Lee JI. Ecthyma gangrenosum in a previously healthy infant. Arch Plast Surg 2012; 39(6): 673–675

[7] Kanj S, Sexton D. Pseudomonas aeruginosa skin, soft tissue and bone infections. UpToDate, Waltham, MA. (Accessed on<Date> September 30</Date>, 2015)

[8] Maschmeyer G, Braveny I. Review of the incidence and prognosis of Pseudomonas aeruginosa infections in cancer patients in the 1990s. Eur J Clin Microbiol Infect Dis 2000; 19(12): 915–925

[9] Chuang CH, Wang YH, Chang HJ, Chen HL, Huang YC, Lin TY, Ozer EA, Allen JP, Hauser AR, Chiu CH. Shanghai fever: a distinct Pseudomonas aeruginosa enteric disease. Gut 2014; 63(5): 736–743

Compliance with ethics guidelines

Wei Phin Tan, Benjamin A. Sherer, and Jerome Hoeksema declare no conflict of interest. This article is a case report and does not involve a research protocol requiring approval by the relevant institutional review board or ethics committee. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients participating in the study.

RIGHTS & PERMISSIONS

2016 Higher Education Press and Springer-Verlag Berlin Heidelberg