[Invasive Pseudomonas aeruginosa and Ecthyma gangrenosum infection in a child without risk factors].

Background: Pseudomonas aeruginosa sepsis, well known in immunocompromised patients, is rare in previously healthy children.
Case Report: A previously healthy 4 month-old boy was admitted with the suspicion of meningococcal septicemia. Three days prior to admission, he had developed high fever and two 4 cm-diameter skin lesions on his right leg, with dark red colour and a central haemorrhagic blister. He subsequently developed generalized seizures; meningitis and urinary tract infection were excluded. Despite topical therapy with an antistaphylococcal drug skin lesions extended, particularly at the level of the head. The patient was given oral amoxicillin-clavulanate, but his condition worsened; he was transferred to our intensive care unit with septic shock and a diagnosis of meningococcemia. Blood cultures grew Pseudomonas aeruginosa. Despite intensive therapy and appropriate antibiotic therapy, the patient died.
Conclusion: To allow early diagnosis and adequate treatment, it is mandatory to diagnose Ecthyma gangrenosum as the most frequent manifestation of invasive infection with Pseudomonas aeruginosa.