Open AccessA fatal case of "bullous erysipelas-like" pseudomonas vasculitis
Author(s) -
Shan Yang,
Nisha Suyien Chandran,
Jin Huang,
Kang Tan,
Derrick Chen-Wee Aw
Publication year - 2016
Publication title -
indian journal of dermatology/indian journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.395
H-Index - 36
eISSN - 1998-3611
pISSN - 0019-5154
DOI - 10.4103/0019-5154.174095
Subject(s) - medicine , erysipelas , vasculitis , bacteremia , septic shock , pseudomonas aeruginosa , dermatology , pathology , sepsis , microbiology and biotechnology , antibiotics , surgery , bacteria , genetics , disease , biology
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 bacteremia. 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