Necrotiserende huidletsels en koorts bij een 8 maanden oude jongen

Abstract

Fever and necrotising skin lesions in an 8-month-old boy The authors present the case of an 8-month-old infant who was brought to the emergency department with a persistent fever, diarrhoea and skin lesions. The initial treatment with intravenous ceftriaxone resulted in fever resolution within 24 hours, but persistent skin lesions prompted further investigation. Secondary cultures revealed Pseudomonas aeruginosa and the skin biopsy showed characteristic histopathological features supporting the diagnosis of ecthyma gangrenosum (EG). The treatment was adjusted based on susceptibility testing. Three weeks of antibiotic therapy (2 weeks of intravenous ceftazidim and 1 week of oral ciprofloxacin) along with intensive wound care resulted in a progressive improvement of the lesions. The immunological screening was normal. This case illustrates the importance of repeated cultures and skin biopsies to confirm the diagnosis. Next, it is crucial to initiate a prompt and accurate antibiotic treatment considering the potential for rapid fatality in untreated septicemic EG cases.