ECTHYMA GANGRENOSUM IN CHILDREN - A REVIE W OF 7 CASES

Seven cases of ecthyma gangrenosum caused by Pseudomonas aeruginosa in infants and young children are reviewed, The skin lesions typically c onsisted of necrotic ulcers surrounded by a red areola, Three patients also had septicemia, All seven patients had underlying abnormalities, including panhypogammaglobulinemia in a five-year-old, hyaline membra ne disease requiring intensive care therapy in a premature infant, Sch wachman syndrome in a 7-month-old, chronic neutropenia in a 16-month-o ld, defective polymorphonuclear cell chemotaxis in a 23-month-old, cyc lic neutropenia in an 18-month-old with atopy, and neutropenia with ly mphopenia and absent T-cell function In a six-month-old, Ecthyma gangr enosum was the inaugural manifestation of the immune deficiency in fou r patients, All patients received antimicrobial therapy, and three als o required surgical drainage. The outcome was favorable in every case, Ecthyma gangrenosum is a rare, often misdiagnosed condition with high ly suggestive clinical features. Most patients have a debilitating dis ease and/or an immune deficiency. The outcome is frequently fatal in t he absence of an early diagnosis with prompt initiation of appropriate antimicrobial therapy. The immune status of the patient should be inv estigated after the episode since ecthyma gangrenosum can be the first manifestation of an immune deficiency.