Korean J Pediatr Infect Dis.  2006 Nov;13(2):180-185. 10.14776/kjpid.2006.13.2.180.

Two Cases of Invasive Pseudomonas aeruginosa Infection that Developed in the Apparently Immunocompetent Infants

• Kang MJ
• Kim SH
• Kim NH
• Lee JA
• Eun BW
• Choi EH
• Lee HJ

• KMID: 2439986
• DOI: http://doi.org/10.14776/kjpid.2006.13.2.180

Abstract

Invasive Pseudomonas infections most often occur in the immunocompromised patients and are associated with high mortality rate. Rarely this disease may develop in healthy infants and children. We report two cases of invasive Pseudomonas aeruginosa infections that were diagnosed in otherwise healthy infants. The first case was a previously healthy 5-month-old infant with ecthyma gangrenosum and septicemia. She presented with fever, swelling of left periorbital area and multiple erythronodular skin lesions. Each skin lesion formed a black eschar surrounded by an erythematous areola over time. Cultures of blood, urine and discharge from skin lesions grew P. aeruginosa. On the day of visit, she showed pancytopenia which was normalized after 10 days. The patient responded well to the management with ceftazidime and tobramycin. The other case was a previously healthy 9-month-old infant with community-acquired pneumonia. He was referred from an outside hospital with fever and cough. Chest x-ray revealed pneumonic infiltrations on both lower lungs with pleural effusion on the right side. Cultures of blood and pleural fluid grew P. aeruginosa. Chest CT performed on the ninth day demonstrated pneumatoceles, lung abscess and necrosis of lung parenchyma. He was managed with ceftazidime and amikacin for 50 days. No residual pulmonary complications were noted during the three month follow-up. Laboratory results to evaluate immunologic defects of phagocytic cells, complement components and T- and B-lymphocytes were all within normal range in both patients. It should be kept in mind that Pseudomonas can be, though uncommon, a cause of community-acquired invasive infections in the previously healthy infants.

Keyword

Pseudomonas aeruginosa; Septicemia; Ecthyma gangrenosum; Pneumonia; Empyema

MeSH Terms

Amikacin
B-Lymphocytes
Ceftazidime
Child
Complement System Proteins
Cough
Ecthyma
Empyema
Fever
Follow-Up Studies
Humans
Immunocompromised Host
Infant*
Lung
Lung Abscess
Mortality
Necrosis
Pancytopenia
Phagocytes
Pleural Effusion
Pneumonia
Pseudomonas aeruginosa*
Pseudomonas Infections
Pseudomonas*
Reference Values
Sepsis
Skin
Thorax
Tobramycin
Tomography, X-Ray Computed
Amikacin
Ceftazidime
Complement System Proteins
Tobramycin