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Pseudomonas aeruginosa folliculitis after shower/bath exposure
1Departments of Dermatology and Microbiology, S. Antonio Abate Hospital, Trapani, Italy.
Background:
Pseudomonas aeruginosa folliculitis (PF) can develop after exposure to contaminated water in heated swimming pools, whirlpools, and hot-tubes, or after diving suit dressing.
Methods:
We observed and studied 14 cases of PF after shower/bath exposure, an underestimated pathogenic event. Cutaneous and environmental microbiological evaluations were performed.
Results:
In our cases, the clinical expression of dermatitis was constant, PF being a clinically well recognizable skin infection, presenting with follicular, macular, and papulopustular lesions located on the lateral aspect of the trunk, axillary folds, hips, buttocks, and suprapubic area. In all cases, Pseudomonas aeruginosa was isolated from lesional skin; seven cases were serotyped revealing, in three cases, serotype 0 : 1, in two cases 0 : 8, in one case 0 : 10, and in one case 0 : 11. In three families, Pseudomonas aeruginosa was isolated in the well water. In a further three families, Pseudomonas aeruginosa was isolated from bathroom and kitchen components.
Conclusions:
Based on our experience, we suggest that shower/bath exposure should be definitively included amongst the possible pathogenic events causing PF. Pseudomonas aeruginosa is responsible for a number of clinical pictures, e.g. otitis externa, conjunctivitis, toe web intertrigo, green nail syndrome, infection of burns and wounds, and folliculitis. Pseudomonas aeruginosa folliculitis (PF) has been reported to develop as a consequence of exposure to contaminated water in heated swimming pools, whirlpools, and hot-tubes, or related to diving suits and leg waxing.1-4 We observed 14 cases of PF after shower/bath exposure. This is probably an underestimated pathogenic event; to our knowledge, only one case has been reported to date.5 In our patients, the clinical expression of dermatitis was constant, PF being a clinically well recognizable skin condition.
Insights
Showering in contaminated water can cause Pseudomonas aeruginosa folliculitis (PF), a recognizable skin infection. This study highlights shower/bath exposure as an underestimated cause of PF, emphasizing the need for awareness.
Area of Science:
- Dermatology
- Microbiology
- Infectious Diseases
Background:
- Pseudomonas aeruginosa folliculitis (PF) is typically linked to contaminated water in recreational settings like pools and hot tubs.
- Exposure to contaminated water in diving suits has also been associated with PF development.
Purpose of the Study:
- To investigate shower/bath exposure as an underestimated cause of Pseudomonas aeruginosa folliculitis (PF).
- To document the clinical presentation and microbiological findings in cases of PF linked to domestic water exposure.
Main Methods:
- Observation and study of 14 cases of PF following shower/bath exposure.
- Performance of cutaneous and environmental microbiological evaluations to identify Pseudomonas aeruginosa.
Main Results:
- All 14 patients presented with a consistent clinical picture of PF, characterized by follicular, macular, and papulopustular lesions.
- Pseudomonas aeruginosa was isolated from lesional skin in all cases, with various serotypes identified.
- The pathogen was also detected in well water and household components (bathroom, kitchen) in affected families.
Conclusions:
- Shower/bath exposure should be recognized as a significant route for developing Pseudomonas aeruginosa folliculitis (PF).
- Pseudomonas aeruginosa can cause diverse clinical manifestations beyond folliculitis, including ear, eye, and skin infections.
- This study underscores the importance of considering domestic water sources in the etiology of PF.