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Ecthyma gangrenosum is known as a characteristic lesion of  Pseudomonas aeruginosa  sepsis and is usually seen in immunocompromised patients.    Case presentation  A previously healthy 63-year-old man was admitted with sloughy necrotic ulcerations of the skin over his sternum. He was afebrile and in good condition. A skin biopsy revealed ecthyma gangrenosum. Blood cultures remained sterile, but a culture of biopsy material grew  Pseudomonas aeruginosa .    Conclusion  Ecthyma gangrenosum may develop even in the absence of bacteremia and even in immunocompetent patients. It should be considered as a possible diagnosis even when a previously healthy patient has negative blood cultures.

Ecthyma gangrenosum without bacteremia in a previously healthy man: a case report