A 44-year-old female presented to OPD with complaints of pallor, fatigue, weakness, palpitations and dyspnea on exeion. Blood tests were conducted, which revealed, Anemia Thrombocytopenia Leukocytosis with neutropenia and increased blasts in the peripheral blood smear. Peripheral blood smear The patient was diagnosed with leukemia and she underwent allogenic stem cell transplantation for the same. After 24 days, she again presented with hypotension, tachycardia, and spO2 of 88% along with a new rash from which biopsy was taken and silver staining was done. Lab findings revealed severe Neutropenia. Which is the most likely organism causing the above skin condition: -
This is a case of ecthyma gangrenosum post allogenic stem cell transplantation for AML. 1st image shows a classical Faggot cell - classically seen in AML. 2nd image shows Ecthyma gangrenosum Typical rash Hemorrhagic vesicles Surrounded by rim of erythema Central necrosis and ulceration Seen in patients with neutropenia Most common organism causing - Pseudomonas aeruginosa Another organism - Aeromonas hydrophila 3rd image shows fat necrosis and numerous bacilli (Pseudomonas).
Pseudomonas
Neisseria meningitidis
Staphylococcus aureus
Vibrio vulnificus
Integrated QBank