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Erythema induratum secondary to Pseudomonas aeruginosa bacteremia in an elderly patient: a rare case report

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Resumo:Abstract Erythema induratum (EI) is a rare form of panniculitis, often associated with tuberculosis but which can be linked to other infections or idiopathic. We report a case of an atypical presentation of EI secondary to Pseudomonas aeruginosa bacteremia. An 84-year-old man with chronic kidney disease on hemodialysis was admitted for left leg cellulitis and Pseudomonas aeruginosa bacteremia. Despite antibiotic therapy, he developed nontender, erythematous nodules on his left leg. Histopathology revealed a mixed-pattern panniculitis consistent with EI. Targeted antibiotic therapy led to overall improvement. EI typically presents in adult women and rarely in elderly men. Differential diagnosis included infectious panniculitis, erythema nodosum and ecthyma gangrenosum. Negative microorganism stainingand a favorable antibiotic response confirmed the diagnosis. This case highlights a rare association of EI with infection by P. aeruginosa and emphasizes the importance of comprehensive diagnostic evaluation in atypical clinical presentations.
Autores principais:Carvalho,Mélissa M. de
Outros Autores:Valejo-Coelho,Margarida M.; Sampaio,Rita
Assunto:Erythema induratum Pseudomonas aeruginosa Nodular vasculitis Panniculitis
Ano:2025
País:Portugal
Tipo de documento:relatório
Tipo de acesso:acesso aberto
Instituição associada:Fundação para a Ciência e Tecnologia
Idioma:inglês
Origem:SciELO Portugal
Descrição
Resumo:Abstract Erythema induratum (EI) is a rare form of panniculitis, often associated with tuberculosis but which can be linked to other infections or idiopathic. We report a case of an atypical presentation of EI secondary to Pseudomonas aeruginosa bacteremia. An 84-year-old man with chronic kidney disease on hemodialysis was admitted for left leg cellulitis and Pseudomonas aeruginosa bacteremia. Despite antibiotic therapy, he developed nontender, erythematous nodules on his left leg. Histopathology revealed a mixed-pattern panniculitis consistent with EI. Targeted antibiotic therapy led to overall improvement. EI typically presents in adult women and rarely in elderly men. Differential diagnosis included infectious panniculitis, erythema nodosum and ecthyma gangrenosum. Negative microorganism stainingand a favorable antibiotic response confirmed the diagnosis. This case highlights a rare association of EI with infection by P. aeruginosa and emphasizes the importance of comprehensive diagnostic evaluation in atypical clinical presentations.