Gangrenous, Hemorrhagic, Bullous Cellulitis Associated with Pseudomonas aeruginosa in a Patient with Waldenstrom's Macroglobulinemia.

摘要

BACKGROUND: Patients with Waldenstrom's macroglobulinemia may manifest several types of skin lesions. We present our experience with a patient with the disease that adds to the literature on the topic. CASE DESCRIPTION: A 57-year-old man with history of multiple sclerosis and Waldenstrom's macroglobulinemia was admitted to the intensive care unit in shock. His family members reported that the patient had complained of fever and the gradual development of gangrenous, hemorrhagic, bullous cellulitis lesions on the abdomen and lower extremities for 7 days prior to his admission to the hospital. Pseudomonas aeruginosa was isolated from fluid specimens collected from the cutaneous lesions. Appropriate antimicrobial treatment including continuous intravenous administration of meropenem (6 g every 24 h) led to the cure of the infection. CONCLUSIONS: We postulate that the underlying Waldenstrom's macroglobulinemia contributed to the pathophysiology of the development of the rare skin manifestations of the infection observed in our patient.