From the Outside Looking In

• Published in: The American journal of medicine Vol. 125; no. 5; pp. 457 - 460
• Main Authors: Moayedi, Yasbanoo, MD, Bunce, Paul E., MD, Sade, Shachar, MD, Ghazarian, Danny, MD, Gold, Wayne L., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-05-2012; Elsevier; Elsevier Sequoia S.A
• Subjects: Adult; Anti-Bacterial Agents - therapeutic use; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Bacteremia - complications; Bacteremia - drug therapy; Bacteremia - microbiology; Bacteria; Biological and medical sciences; Drug therapy; Emergency medical care; General aspects; Humans; Immunocompromised Host; Internal Medicine; Lymphoma; Lymphoma, B-Cell - drug therapy; Male; Medical sciences; Mens health; Neutropenia - chemically induced; Neutropenia - complications; Pseudomonas aeruginosa - isolation & purification; Pseudomonas Infections - diagnosis; Pseudomonas Infections - microbiology; Pseudomonas Infections - pathology; Skin diseases; Skin Diseases, Bacterial - diagnosis; Skin Diseases, Bacterial - microbiology; Skin Diseases, Bacterial - pathology; Medicine
• ISSN: 0002-9343; 1555-7162
• DOI: 10.1016/j.amjmed.2011.10.021

Moayedi et al present the case of a 41-year-old man with stage IV T-cell-rich B-cell lymphoma. He was presented to emergency department reporting a 2-day history of fever, diarrhea, and malaise and a 3-week history of multiple tender, erythematous skin leasions located on his arms, trunk, and lower extremities. The recognition of the patient's skin lesions as ecthyma gangrenosum and the appreciation of this condition's strong association with P. aeruginosa bacteremia led to empiric treatment with two anti-pseudomonal agents, piperacillin-tazobactam and ciprofloxacin, to ensure adequate antimicrobial coverage while culture and susceptibility results were pending.