Evidence map›Paper›PMID 33845789›Full record

ArticleBMC infectious diseases2021

An Eschar-like souvenir from a journey to Colombia: Ecthyma gangrenosum as a differential diagnosis of tropical diseases in immunocompromised patients - a case report.

Gabriela M Wiedemann, Jochen Schneider, Mareike Verbeek, Björn Konukiewitz, Christoph D Spinner, Henrik Einwächter, Roland M Schmid, Kathrin Rothe

Open access · goldAbstract readCase Reports
In one paragraph

Article in BMC infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 44% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Gabriela M WiedemannDepartment of Internal Medicine II, University hospital rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany. gabriela.wiedemann@gmail.com.ORCID http://orcid.org/0000-0001-6138-9791
Jochen SchneiderDepartment of Internal Medicine II, University hospital rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany.
Mareike VerbeekDepartment of Internal Medicine III, University hospital rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany.
Björn KonukiewitzInstitute of Pathology, Technical University of Munich, School of Medicine, Munich, Germany.
Christoph D SpinnerDepartment of Internal Medicine II, University hospital rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany.
Henrik EinwächterDepartment of Internal Medicine II, University hospital rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany.
Roland M SchmidDepartment of Internal Medicine II, University hospital rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany.
Kathrin RotheGerman Center for Infection Research (DZIF), partner site Munich, Munich, Germany.
TUM Klinikum · DEGerman Center for Infection Research · DETechnical University of Munich · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEcthyma gangrenosum (EG) is a cutaneous infectious disease characterized by eschar-like skin ulcers typically caused by Pseudomonas aeruginosa. Here, we report a case of relapsing EG in a patient who had returned from a trip to Colombia, thus establishing EG as an important differential diagnosis of tropical diseases, and demonstrating that even long-term antibiotic treatment can result in only partial remission of EG. CASE PRESENTATION: A 77-year-old man with underlying chronic lymphocytic leukemia (CLL) on ibrutinib treatment was admitted because of a superinfected mosquito bite on the left ear and multiple partially necrotic skin lesions disseminated all over the entire body five days after returning from a trip to Colombia. The initial clinical suspicion of a tropical disease (leishmaniosis, systemic mycosis, or others) could not be confirmed. During the diagnostic workup, microbiological cultures of the skin biopsies and bronchoalveolar lavage revealed Pseudomonas aeruginosa, leading to a diagnosis of EG. Initial antibiotic treatment resulted in partial remission. However, the patient had to be re-admitted due to a relapse 3-4 weeks after the first episode. Finally, the patient was successfully treated with a combined approach consisting of antibiotics, recurrent surgical incisions, and administration of immunoglobulins.

conclusionsIn conclusion, EG should be considered as a differential diagnosis in immunosuppressed patients presenting with eschar-like skin ulcers. A combined treatment approach seems to be the best choice to achieve clinical cure and avoid relapse.

Indexed as

AdenineAdministration, IntravenousAgedAnti-Bacterial AgentsBronchoalveolar Lavage FluidColombiaDiagnosis, DifferentialEcthymaHumansImmunocompromised HostImmunoglobulinsLeukemia, Lymphocytic, Chronic, B-CellMalePiperidinesPseudomonas aeruginosaSkin UlcerAdenineAnti-Bacterial AgentsibrutinibImmunoglobulinsPiperidinesCase reportEcthyma gangrenosumIbrutinibLeukemiaPseudomonas aeruginosaSkin ulcerTropical disease

Identifiers

PMID33845789
PMCPMC8042936
OpenAlexW3152571010

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.