A 55-year-old man arrives at the emergency room with a fever and chills. He has a history of acute myeloid leukemia and is now undergoing treatment. His temperature is 38.3 degrees Celsius (101 degrees Fahrenheit), his blood pressure is 90/50 mm Hg, his pulse rate is 124 beats per minute, and his respirations are 22 per minute. Multiple skin patches with necrotic cores and occasional ulcerations are visible on physical inspection, as illustrated in the figure below. Laboratory results are as follows: Blood cultures are drawn. Which of the following organisms is most likely responsible for this patient's symptoms?

Question

A 55-year-old man arrives at the emergency room with a fever and chills. He has a history of acute myeloid leukemia and is now undergoing treatment. His temperature is 38.3 degrees Celsius (101 degrees Fahrenheit), his blood pressure is 90/50 mm Hg, his pulse rate is 124 beats per minute, and his respirations are 22 per minute. Multiple skin patches with necrotic cores and occasional ulcerations are visible on physical inspection, as illustrated in the figure below.  Laboratory results are as follows:  Blood cultures are drawn.  Which of the following organisms is most likely responsible for this patient's symptoms?

Quizplus · Accepted Answer

Eductional Objective: Ecthyma gangrenosum is a cutaneous necrotic disease linked to Pseudomonas aeruginosa bacteremia. It is caused by perivascular invasion and the production of tissue-destructive exotoxins, which causes vascular damage and inadequate blood supply to regions of skin, leading them to become edematous and necrose. Infections caused by Pseudomonas are prevalent in people who are neutropenic, hospitalized, have burns, or have indwelling catheters.

A 55-Year-Old Man Arrives at the Emergency Room with a Fever