Surgical Treatment Modalities of Ecthyma Gangrenosum in Children: Report of 3 cases and Review of the Literature for Pediatric Patients

Abstract

Ecthyma Gangrenosum (EG) is usually a-sudden-onset disease affecting multiple regions of body with various symptoms and findings. Although the problem is seemed to be consequence of infections like Pseudomonas aeruginosa, some unpredictable causes may involve in it. Due to the rapid onset of the disease, practitioners are often unprepared for the EG. We are also qualified for treating lesions caused by burns but not EG.  Although we were also unrehearsed for EG treatment, our facility was one of the experienced tertiary care children’s hospitals. Therefore, we were able to accomplish the problem in these 3 patients. Herein, we shared our treatment plots of EG. We believe these experiences will be helpful to comprehend alternative management protocols when treatment disappointments were observed during clinical progress.

Keywords

• Ecthyma,Gangrenosum,Children,Surgery

Çocuklarda Ecthyma Gangrenosum'un Cerrahi Tedavi Yöntemleri: 3 Olgu Sunumu ve Pediatrik Hastalar için Literatürün Gözden Geçirilmesi

Abstract

Ecthyma Gangrenosum (EG) genellikle çeşitli semptom ve bulgularla vücudun çeşitli bölgelerini etkileyen ani başlangıçlı bir hastalıktır. Sorun Pseudomonas aeruginosa gibi enfeksiyonların bir sonucu gibi görünse de, bazı öngörülemeyen nedenler buna dahil olabilir. Hastalığın hızlı başlangıcı nedeniyle, uygulayıcılar genellikle EG için hazırlıksızdır. Yanıkların neden olduğu ancak EG'nin neden olduğu lezyonları tedavi etmek için de kalifiye olduk. EG tedavisi için de anlaşılmasa da, tesisimiz deneyimli üçüncül bakım çocuk hastanelerinden biriydi. Bu nedenle, bu 3 hastada problemi başarabildik. Burada EG'nin tedavi alanlarımızı paylaştık. Klinik ilerlemede tedavi hayal kırıklıklarının görüldüğü durumlarda bu deneyimlerin alternatif yönetim protokollerini kavramaya yardımcı olacağına inanıyoruz.

Keywords

• Cerrahi,Tedavi,Ecthyma Gangrenosum,Çocuklar

References

1. 1- Goolamali SL, Fogo A, Killian L, Shaikh H, Brathwaite N, Ford-Adams M, Macfarlane S. Ecthyma gangrenosum: an important feature of pseudomonal sepsis in a previously well child. Clinical and Experimental Dermatology 2008, 34, e180–e182
2. 2- Pacha O, Hebert AA. Ecthyma Gangrenosum and Neutropenia in a Previously Healthy Child. Pediatric Dermatology Vol. 30 No. 6 e283–e284, 2013
3. 3-Khalil BA, Baillie CT, Kenny SE, Lamont GL, Turnock RR, Pizer BL, van Saene HFK , Losty PD. Surgical strategies in the management of ecthyma gangrenosum in paediatric oncology patients. Pediatr Surg Int (2008) 24:793–797
4. 4- Yan W, Li W, Chanmu MD, Linwang BA,. Ecthyma gangrenosum and multiple nodules: cutaneous manifestations of pseudomonas aeruginosa sepsis in a previously healthy infant. Pediatric dermatology vol. 28 no. 2 march ⁄ april 2011.204-205.
5. 5- Vaiman M, Lazarovitch T, Heller L , Lotan G. Ecthyma gangrenosum and ecthyma-like lesions: review article. Eur J Clin Microbiol Infect Dis (2015) 34:633–639
6. 6- Bakalli I, Sallabanda S, Kola E, Lluka R, Zavalani F, Petrela R, Gjyzeli E. Clinical and therapeutic data of a child with ecthyma Gangrenosum. Acta Medica Academica 2010;39:205-208
7. 7- Fang LC, Peng CC, Chi H, Lee KS, Chiu NC. Pseudomonas aeruginosa sepsis with ecthyma gangrenosum and pseudomembranous pharyngolaryngitis in a 5-month-old boy. Journal of Microbiology, Immunology and Infection (2014) 47, 158-161.
8. 8- Pechter PM, Marchione R, Milikowski C, Berman B. Ecthyma Gangrenosum Secondary to Staphylococcus aureus in an Infant with Transient Neutropenia. Pediatric Dermatology Vol. 29 No. 3 320–323, 2012

9. 9- Pulido J, McMahon P, Treat JR, Gunselman J, Tasian GE, Tasian SK. Labial Ecthyma Gangrenosum in an Immunocompromised Infant With Leukemia: Heightening Awareness for the Urologist Urology 80: 1366e1368, 2012
10. 10- Pathak A, Singh P, Yadav Y, Dhaneria M. Ecthyma gangrenosum in a neonate: not always pseudomonas. BMJ Case Rep 2013. doi:10.1136/bcr-2013-009287
11. 11- Prindaville B, Nopper AJ, Lawrence H, Horii KA. Chronic granulomatous disease presenting with ecthyma gangrenosum in a neonate. J Am Acad Dermatol Volume 71, Number 2 e44-45.
12. 12- Gargouria L, Maaloulb I, Kamounb T, Maaleja B, Safia F, Majdouba I, Hachichab M, Mahfoudha A. Ecthyma gangrenosum: A manifestation of community-acquired Pseudomonas aeruginosa septicemia in three infants. Archives de Pe´diatrie 2015;22:616-620