TY - CHAP M1 - Book, Section TI - Ecthyma Gangrenosum A1 - Hardin, J. Matthew A2 - Knoop, Kevin J. A2 - Stack, Lawrence B. A2 - Storrow, Alan B. A2 - Thurman, R. Jason PY - 2021 T2 - The Atlas of Emergency Medicine, 5e AB - Ecthyma gangrenosum is a cutaneous manifestation of Pseudomonas aeruginosa septicemia occurring in an immunocompromised or neutropenic patient. A toxic appearance with fever, abnormal vital signs, and altered consciousness is common. The initially erythematous macules develop bullae or pustules surrounded by violaceous halos. Bullae become hemorrhagic and rupture (pustules breakdown), becoming necrotic ulcers with central black or gray eschars. The time course from macule to eschar can occur within 12 to 24 hours. The lesions primarily affect the anogenital areas (> 50%) but may appear anywhere on the body. Ecthyma gangrenosum is seen in up to 13% of patients with P aeruginosa septicemia and rarely in nonbacteremic patients. Other bacteria causing septicemia (Aeromonas hydrophila, Aspergillus, Burkholderia cepacia, Candida, Citrobacter freundii, Escherichia coli, Fusarium, Pseudomonas stutzeri) may present with similar ecthyma gangrenosum–like lesions. SN - PB - McGraw-Hill CY - New York, NY Y2 - 2024/03/28 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1181043863 ER -