Erysipelaslike Lesions and Hyperesthesia as Manifestations of Pseudomonas aeruginosa Sepsis

PSEUDOMONAS aeruginosa is an important cause of sepsis in immunocompromised patients. 1 Systemic infection with P aeruginosa may have a variety of dermatologic manifestations, including ecthyma gangrenosum, 2 deep-seated nodules, 3,4 abscesses, vesicles, and cellulitis. 5,6 We describe a leukemic patient with different cutaneous manifestations of P aeruginosa infection. Report of a Case A 20-year-old man went to his local physician with a history of fever, malaise, and sore throat. A right peritonsillar abscess and hepatosplenomegaly were present. The abscess was incised but not cultured. Hematocrit value was 26%; WBC count, 16,200/cu mm, with 43% blast forms; and platelet count, 3,000/cu mm. Bone marrow aspiration confirmed the diagnosis of acute lymphocytic leukemia (null cell). The patient was hospitalized, and therapy with vincristine sulfate, prednisone, and asparaginase was begun. Profound neutropenia (WBC count, 200/cu mm) developed. Blood, platelet, and WBC transfusions were given, and intravenous (IV) administration of oxacillin sodium, 65