A Fatal Case of "Bullous Erysipelas-like" Pseudomonas Vasculitis

Erysipelas is a generally benign superficial bacterial skin infection, and its bullous form constitutes a rare and more severe variant. We describe the first and fatal case of "bullous erysipelas-like" septic vasculitis due to Pseudomonas bacteremi. A 69-year-old Chinese man presenting wit...

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Bibliographic Details
Published in:Indian journal of dermatology 2016-01, Vol.61 (1), p.120-120
Main Authors: Yang, Sam Shiyao, Chandran, Nisha Suyien, Huang, Jing Xiang, Tan, Kong-Bing, Aw, Derrick Chen-Wee
Format: Article
Language:English
Subjects:
Bullous erysipelas
Case studies
Diagnosis
E-IJD Case Report
leukocytoclastic vasculitis
Pseudomonas infections
septic vasculitis
Vasculitis
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Summary:Erysipelas is a generally benign superficial bacterial skin infection, and its bullous form constitutes a rare and more severe variant. We describe the first and fatal case of "bullous erysipelas-like" septic vasculitis due to Pseudomonas bacteremi. A 69-year-old Chinese man presenting with diarrhea and septic shock initially began to rapidly develop sharply defined erythematous plaques with non-hemorrhagic bullae over his lower limbs. Culture of the aspirate from the bullae was positive for Pseudomonas aeruginosa. This was also consistent with his blood cultures showing Pseudomonas bacteremia. Histology of the skin lesion showed microthrombi and neutrophilic infiltrates in blood vessels with Gram-negative bacilli extruding from the vessel walls, characteristic of septic vasculitis. The bullous erysipelas-like lesions seen in this patient represents a rare manifestation of both septic vasculitis and Pseudomonas infection.
ISSN:0019-5154
1998-3611
DOI:10.4103/0019-5154.174095