Ecthyma Gangrenosum in 5-Month-Old Long-Term Ventilated Infant: A Case Report

Rationale: Ecthyma gangrenosum (EG) is an aggressive cutaneous disease caused by local or systemic infection with Pseudomonas aeruginosa. EG is characterized by cutaneous manifestations ranging from nodule and papule to necrotic ulceration with surrounding erythema, especially with black eschar or central crust. EG presents with characteristic skin lesions which is important to establish diagnosis of sepsis caused by P aeruginosa, a serious condition that can be treated efficiently if diagnosed early. Patient concerns: A 5-month-old male infant, case of Severe HIE, Ventilatory dependent with Tracheostomy, NGT feeding, Epilepsy and dystonia admitted to Cambridge Medical and rehabilitation Center (CMRC)–AUH -UAE. Developed characteristic skin lesions of EG and developed sepsis. Diagnoses: Ecthyma gangrenosum and sepsis caused by Pseudomonas aeruginosa. Interventions: Meropenem was used in combination with Vancomycin at first and then continued only with Meropenem. Outcomes: Cure. Lessons: Early recognition of EG plays an important role in providing appropriate empiric antibiotic treatment at early stage and improves the prognosis. Close clinical follow up on skin lesion evolution is an alternative to possible invasive management.