Orbital ecthyma gangrenosum in multiple myeloma

Abstract

Ecthyma gangrenosum is a rare and highly lethal cutaneous infection classically associated with Pseudomonas aeruginosa bacteremia. We report a 58-year-old man with multiple myeloma receiving chemotherapy who presented with 2 days of painless left periorbital swelling that rapidly progressed to a blackish eschar. His absolute neutrophil count was 0.10/mm³; platelet count, 14,000/mm³; and hemoglobin, 6 g/dL. Computed tomography showed diffuse left periorbital cellulitis. Blood cultures grew pan-sensitive Pseudomonas aeruginosa, and the patient died from sepsis and multiorgan failure.

Keywords:

• Black eschar
• ecthyma gangrenosum
• Pseudomonas bacteremia
• sepsis

ACKNOWLEDGMENTS

The authors thank the Division of Hematology and Oncology at Texas Health Presbyterian Hospital of Dallas for their help and support.