Ecthyma gangrenosum
Another reason to make sure you check you sugars! Can you guess the diagnosis? 👇 Pictured here is a patient with ecthyma gangrenosum! Ecthyma gangrenosum is a soft tissue infection traditionally caused by pseudomonas aeruginosa. Ecthyma gangrenosum is different from skin infections in that ecthyma gangrenosum results from perivascular bacterial invasion of the media and adventita of the arteries and veins, resulting in ischemic necrosis. Pseudomonas is unique to the pathogenesis of this condition because it produces several toxins that encourage tissue degradation. Traditionally the disease starts as a red macules, when then turn into bullae, and then eventually turn into gangrenous ulcers. Traditionally the diagnosis, is made clinically although blood cultures and wound cultures are often performed to identify non pseudomonal organisms. Patients are treated with broad spectrum therapy with activity against pseudomonas: traditionally with Cefepime or piperacillin- tazobactam. Remember that patients with diabetes are at an increased risk for pseudomonal infections! Check those sugars and reinforce the importance of diet and exercise! Credit: @themedicalmentors
