Ecthyma gangrenosum caused by Stenotrophomonas maltophilia in a neutropenic leukaemic infant: A case report

Abstract

Ecthyma gangrenosum (EG) is a cutaneous lesion, mostly caused by pseudomonas in immunocompromised patients. Other bacterial and fungal pathogens have also been reported. It can occasionally affect previously healthy children. The cutaneous findings are characterised by small indurated papulovesicles, progressing rapidly to necrotic ulcers with surrounding erythema and a central black eschar. Sites most commonly involved are the buttocks, perineum, limbs and axillae; the face is less commonly involved. We are presenting a rare case of EG in a neutropenic infant who had just completed the induction phase of chemotherapy for acute lymphoblastic leukaemia. The gangrenous lesion was on the face involving the tip of the nose, which is an uncommon location. Blood and pus cultures grew Stenotrophomonas maltophilia, which is a rare cause of EG. The patient was treated with IV antibiotics (colistin for 14 days) and improved.