Ecthyma Gangrenosum Caused by Pseudomonas aeruginosa
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Charles S. Pavia
To the Editor:
We read with interest the report by Rock and Thom1 published in the April issue of JAOA—The Journal of the American Osteopathic Association. There is an important aspect of this report worth noting: the pseudomonal lesion depicted in the image closely resembles an eschar. This resemblance underscores the importance of obtaining as complete and as concise as possible of a patient history that includes social, recreational, occupational, and travel-related activities. For example, cutaneous eschars are associated with certain zoonotic infections such as anthrax,2 tularemia,3 and African tick-bite fever.4 Anthrax and tularemia are considered agents of bioterrorism,2 but they can also be acquired as part of recreational activities (eg, wild game hunting) or occupational activities (eg, those of farmers, veterinarians, abattoir workers, or taxidermists) during natural exposure to infected animals or their products. African tick-bite fever is endemic primarily in the southern (ie, sub-Sahara) regions of Africa; so, recent travel there would have to be ruled out.
References
1 Rock C Thom K . Ecthyma gangrenosum caused by Psedumonas aeruginosa [Clinical Images][published correction appears in J Am Osteopath Assoc. 2012;112(7):466]. J Am Osteopath Assoc.2012;112(4):240.Search in Google Scholar
2 Centers for Disease Control and Prevention . Anthrax: images: cutaneous anthrax. Centers for Disease Control and Prevention Web site. http://www.bt.cdc.gov/agent/anthrax/anthrax-images/cutaneous.asp. Accessed June 13, 2012.Search in Google Scholar
3 Edouard S Gonin K Turc Y Angelakis E Socolovschi C Raoult D . Eschar and neck lymphadenopathy caused by Francisella tularensis after a tick bite: a case report. J Med Case Rep.2011;5:108.10.1186/1752-1947-5-108Search in Google Scholar PubMed PubMed Central
4 Althaus F Greub G Raoult D Genton B . African tick-bite fever: a new entity in the differential diagnosis of multiple eschars in travelers—description of five cases imported from South Africa to Switzerland. Int J Infect Dis.2010;14(suppl 3):e274-e276.10.1016/j.ijid.2009.11.021Search in Google Scholar PubMed
© 2012 The American Osteopathic Association
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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Articles in the same Issue
- AOA Communication (Reprints)
- Official Call
- Proposed Amendments to the AOA Constitution and Code of Ethics and New “Rules and Guidelines”
- Letters
- Efficacy of a Physician's Words of Empathy: An Overview of State Apology Laws
- Ecthyma Gangrenosum Caused by Pseudomonas aeruginosa
- The Somatic Connection
- “How much lymph can a lymph pump pump if a lymph pump can pump lymph?”
- Myofascial Release Therapy's Effect on Immune System in Breast Cancer Survivors Modulated by Positive Attitude
- Myofascial Trigger Point Massage Reduces Pain of Chronic Tension-Type Headache
- Massage Shown to Benefit Patients With Chronic Low Back Pain
- Oropharyngeal Exercises Improve Sleep Apnea
- Adjunctive OMT May Improve Exercise Capacity for Patients With Severe COPD
- Special Reports
- Joining Forces Initiative: Steps Toward Improved Care for Military Personnel
- Military Medicine Content in an Osteopathic Medical School's Curriculum
- Original Contributions
- Somatic Dysfunction and Its Association With Chronic Low Back Pain, Back-Specific Functioning, and General Health: Results From the OSTEOPATHIC Trial
- Cervical Spine Bending: A Factor Confounding Whole Trunk and Lumbar Forward Bending Range of Motion
- Use of and Attitudes Toward Complementary and Alternative Medicine Among Osteopathic Medical Students
- Special Communication
- A New Triadic Paradigm for Osteopathic Research in Real-World Settings
- Case Report
- Osteopathic Manipulative Treatment to Resolve Head and Neck Pain After Tooth Extraction
- Clinical Images
- Sister Mary Joseph Nodule From Prostate Cancer
- Letters
- Acute Myeloid Leukemia, Genetics, and Risk Stratification: Data Overload or Ready for a Breakthrough?
- Thinking Osteopathically
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