RT Book, Section A1 Schaffer, Julie V. A1 Chang, Mary Wu A2 Zaoutis, Lisa B. A2 Chiang, Vincent W. SR Print(0) ID 1146115782 T1 Ecthyma Gangrenosum T2 Comprehensive Pediatric Hospital Medicine, 2e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071829281 LK accesspediatrics.mhmedical.com/content.aspx?aid=1146115782 RD 2024/03/29 AB In 1897, Barker first described skin lesions evolving from erythematous macules to vesicles to necrotic ulcers in the setting of septicemia secondary to Pseudomonas aeruginosa.1 In the same year, Hitschmann and Kreibich coined the term ecthyma gangrenosum (EG) for this characteristic cutaneous manifestation of pseudomonal septicemia.2 Although P. aeruginosa is the classic pathogen in EG, other infectious organisms can produce clinically identical lesions (Table 62-1).3 Regardless of the causative organism, EG has a predilection for immunocompromised hosts, particularly individuals with neutropenia and hematologic malignancies.4 However, EG can also occur in previously healthy children, sometimes representing the initial presentation of a primary or acquired immunodeficiency. EG is currently considered as a morphologic pattern of cutaneous necrosis that results from occlusion of blood vessels by organisms proliferating within their walls, usually but not always associated with bacteremia or fungemia. EG tends to progress rapidly and has a high mortality rate without treatment, so early recognition and prompt administration of antimicrobial therapy are essential.