Pseudomonas cepacia endocarditis and ecthyma gangrenosum

Area of Science:

• Infectious Diseases
• Cardiology
• Dermatology

Background:

• Endocarditis, an infection of the heart lining, can be caused by various bacteria.
• Pseudomonas cepacia (now Burkholderia cepacia complex) is an opportunistic pathogen.
• Ecthyma gangrenosum is a specific type of skin lesion associated with bacterial sepsis, most commonly Pseudomonas aeruginosa.

Observation:

• A case of right-sided endocarditis was identified in a patient with a history of heroin use.
• Septic cutaneous vasculitis, presenting as ecthyma gangrenosum, was a prominent clinical feature in this patient.
• The endocarditis was attributed to Pseudomonas cepacia.

Findings:

• This report describes the first documented case of ecthyma gangrenosum occurring in the context of Pseudomonas cepacia septicemia.
• The findings expand the known clinical spectrum of ecthyma gangrenosum, previously associated primarily with P. aeruginosa.

Implications:

• Clinicians should consider Pseudomonas cepacia as a potential cause of ecthyma gangrenosum, particularly in at-risk populations.
• This case highlights the importance of recognizing diverse clinical presentations of bacterial endocarditis and associated septic complications.
• Further research may elucidate the mechanisms by which P. cepacia induces ecthyma gangrenosum.