Ecthyma Gangrenosum of Fungal Origin: A Case Report

dc.contributor.authorLeón Sánchez, Germán Andrés
dc.contributor.authorLozada Ramos, Heiler
dc.contributor.authorDaza Arana, Jorge Enrique
dc.contributor.authorRestrepo Becerra, Andrés Darío
dc.contributor.authorVarela Miranda, Ruben
dc.date.accessioned2025-07-08T15:25:03Z
dc.date.available2025-07-08T15:25:03Z
dc.date.issued2024
dc.description.abstractIntroduction: Ecthyma gangrenosum (EG) is usually a dermatologic manifestation of a Pseudomonas aeruginosa infection in an immunocompromised individual but may sometimes be caused by other bacteria or fungi in an immunocompromised or nonimmunocompromised individual. Case Presentation: A 75-year-old woman with a history of high blood pressure and sequels of ischemic cerebral infarction presented with a 5-day history of general malaise, cough with yellow sputum, and respiratory distress. The patient had pale mucous membranes, temperature of 38.5°C, tachycardia, normal blood pressure, SaO2 of 85%, intercostal retractions, and severe bronchospasm upon hospital admission. No skin lesions were seen. The patient was admitted to the intensive care unit (ICU) because of her critical condition and was supported with invasive mechanical ventilation. Her blood count showed 8,100 leukocytes/mm3, neutrophils 79%, hemoglobin 10.1 g/dL, creatinine 1.1 mg/dL, and C-reactive protein 328 mg/dL. Arterial blood gases showed metabolic acidosis and moderate hypoxemia. The initial report of blood and urine cultures was negative for bacteria, and positive for influenza A H1N1. The patient was treated with oseltamivir and intravenous methylprednisolone for acute respiratory distress syndrome associated with the viral infection that occurred. Subsequently, violaceus macular and papular lesions appeared, which evolved into ulcerated lesions with erythematous border and necrotic center were seen in the anterior region of the chest and abdomen, from where Candida metapsilosis was isolated. EG was reported in this patient, who was also immunocompromised because of steroid use, had a prolonged stay in the ICU and received broad-spectrum antibiotics. Fungemia and urinary infection due to different fungi were also found. Conclusion: It is worth mentioning that EG can be caused by germs other than P. aeruginosa and fungal infections should not be ruled out.
dc.identifier.citationGermán Andrés León-Sánchez, Heiler Lozada-Ramos, Jorge Enrique Daza-Arana, Andrés Darío Restrepo-Becerra, Ruben Varela-Miranda; Ecthyma Gangrenosum of Fungal Origin: A Case Report. Case Rep Dermatol 18 December 2024; 16 (1): 240–247. https://doi.org/10.1159/000542105
dc.identifier.issn16626567
dc.identifier.urihttps://repositorio.usc.edu.co/handle/20.500.12421/7236
dc.language.isoen
dc.publisherS. Karger AG
dc.subjectCandida
dc.subjectEcthyma gangrenosum
dc.subjectFungal infection
dc.subjectSteroids
dc.titleEcthyma Gangrenosum of Fungal Origin: A Case Report
dc.typeArticle

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