Opportunistic infection of chronic skin ulcers with Pseudomonas putrefaciens

Area of Science:

• Microbiology
• Dermatology
• Infectious Diseases

Background:

• Leprosy, a chronic infectious disease, can lead to debilitating complications such as chronic ulcers.
• Gram-negative bacterial infections, including those caused by Pseudomonas species, are common in chronic wounds.
• Elderly patients with compromised immune systems are particularly susceptible to persistent infections.

Observation:

• Heavy growth of Pseudomonas putrefaciens was consistently isolated from chronic leg ulcers in an elderly patient with inactive leprosy.
• The patient's ulcers were polymicrobial, with other Gram-negative rods present in mixed culture alongside P. putrefaciens.
• The chronic ulcers were located on the extremities and indicated a long-standing, difficult-to-treat condition.

Findings:

• Systemic cotrimoxazole and topical framycetin were administered as treatment.
• General supportive therapy was provided to the patient.
• The chronic ulcers showed gradual healing over a 4-week period following the intervention.

Implications:

• This case highlights the potential role of Pseudomonas putrefaciens in the pathogenesis of chronic ulcers in leprosy patients.
• Combination therapy including systemic and topical antimicrobials can be effective in managing such complex infections.
• Further research into the specific contribution of P. putrefaciens to chronic wound healing in leprosy is warranted.