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Ecthyma gangrenosum caused by Citrobacter freundii
Tyson Hawkley1, David Chang2, Whitney Pollard3
1Department of Anesthesiology, Brooke Army Medical Center, Fort Sam Houston, Texas, USA.
BMJ Case Reports
|July 29, 2017
Summary
A rare skin infection, ecthyma gangrenosum caused by Citrobacter freundii, occurred in an immunocompromised patient. Prompt antibiotic treatment and port removal led to a full recovery.
Area of Science:
- Infectious Diseases
- Dermatology
- Oncology
Background:
- Chemotherapy for recurrent multiple myeloma can lead to immunosuppression.
- Immunosuppression increases the risk of opportunistic infections.
Observation:
- A 55-year-old man presented with a painful, edematous rash on his lower legs.
- Physical examination revealed non-palpable, retiform, pruritic patches.
- Skin biopsy showed a neutrophilic infiltrate with necrosis.
Findings:
- Cultures of blood and skin tissue isolated Citrobacter freundii.
- The presentation was consistent with ecthyma gangrenosum, a rare bacterial skin infection.
- This infection was linked to the patient's underlying immunosuppression.
Implications:
- Early identification and treatment of ecthyma gangrenosum are crucial for patient recovery.
- This case highlights the importance of monitoring for infectious complications in immunocompromised patients.
- Appropriate antibiotic therapy and removal of potential sources of infection (e.g., medical ports) are key management strategies.
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