Gangrene of the genitalia in children with pseudomonas sepsis

Area of Science:

• Pediatric Oncology
• Infectious Diseases
• Dermatology

Background:

• Increasing incidence of Pseudomonas aeruginosa bacteremia necessitates improved diagnostic and therapeutic strategies.
• Granulocytopenia, often associated with acute leukemia, heightens susceptibility to severe bacterial infections.
• Ecthyma gangrenosum is a recognized but uncommon skin manifestation of Pseudomonas aeruginosa bacteremia.

Observation:

• Five pediatric patients with acute leukemia and granulocytopenia presented with ecthyma gangrenosum over a four-year period.
• Lesions typically appear on extremities, buttocks, or perineum.
• Two patients presented with isolated genital lesions, leading to penile and labial gangrene, respectively.

Findings:

• Ecthyma gangrenosum in immunocompromised children, particularly those with acute leukemia, can manifest with severe genital involvement.
• Prompt recognition of these skin lesions is critical for timely intervention.
• Histopathologic review confirms the characteristic pathology of Pseudomonas aeruginosa infection.

Implications:

• Early identification of ecthyma gangrenosum, even with atypical genital presentation, can guide aggressive antimicrobial therapy.
• This highlights the importance of a multidisciplinary approach involving oncology, infectious disease, and dermatology for managing Pseudomonas aeruginosa bacteremia in high-risk pediatric patients.
• Timely diagnosis and treatment of ecthyma gangrenosum can prevent severe complications like gangrene.