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Cutaneous septic embolism presenting as erythematous plaques.

Galve J, Giavedoni P, Alós L, Alsina-Gibert M - Ann Dermatol (2013)

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.

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Dear Editor: Intravascular devices such as prosthetic vascular grafts are therapeutic tools of fundamental importance for patients with several vascular diseases... An 'erythematous plaque' eruption due to septic embolism from an infected prosthetic aortic graft is being reported... Clinical findings of cutaneous septic embolism are variable: palpable purpura, petechiae, hemorrhagic plaques, pustules, nodules, digital cyanosis and livedo reticularis have been described... Osler nodes and Janeway lesions are special forms of septic emboli presentations, commonly associated with bacterial endocarditis... On the other hand, erythematous plaques have been poorly described in the literature... Cutaneous septic embolism biopsy determines the presence of thrombus of neutrophil in dermal blood vessels, although bacteria are usually not detected... Once the diagnosis of infected emboli in patients carrying vascular devices is made, empiric broad-spectrum antibiotic therapy should start immediately... Our patient presented erythematous plaques due to infectious emboli with no evident of clinical signs of sepsis... Histopathology aids us to establish a diagnosis... Unfortunately, the patient died after the surgery... Erythematous plaques eruption should be taken into account as a clinical form of cutaneous septic emboli.

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Related in: MedlinePlus

(A) Skin biopsy showing deep dermis vessels with luminal occlusion due to the presence of neutrophils and fibrinoid material (H&E, ×20). (B) Detail at high magnification showing an intraluminal neutrophil thrombus in the deep dermis vessels (H&E, ×100).
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Figure 2: (A) Skin biopsy showing deep dermis vessels with luminal occlusion due to the presence of neutrophils and fibrinoid material (H&E, ×20). (B) Detail at high magnification showing an intraluminal neutrophil thrombus in the deep dermis vessels (H&E, ×100).

Mentions: Blood tests showed increased plasma creatinine (3.2 mg/dl; reference: 0.3~1.3 mg/dl) and C-reactive protein (26.76 mg/dl; reference: <1 mg/dl) with 89% neutrophilia. Chest X-rays and urine sediments were normal. A skin biopsy was performed showing intraluminal neutrophil thrombi in the deep dermis vessels, suggesting cutaneous septic embolism (Fig. 2).


Cutaneous septic embolism presenting as erythematous plaques.

Galve J, Giavedoni P, Alós L, Alsina-Gibert M - Ann Dermatol (2013)

(A) Skin biopsy showing deep dermis vessels with luminal occlusion due to the presence of neutrophils and fibrinoid material (H&E, ×20). (B) Detail at high magnification showing an intraluminal neutrophil thrombus in the deep dermis vessels (H&E, ×100).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3756217&req=5

Figure 2: (A) Skin biopsy showing deep dermis vessels with luminal occlusion due to the presence of neutrophils and fibrinoid material (H&E, ×20). (B) Detail at high magnification showing an intraluminal neutrophil thrombus in the deep dermis vessels (H&E, ×100).
Mentions: Blood tests showed increased plasma creatinine (3.2 mg/dl; reference: 0.3~1.3 mg/dl) and C-reactive protein (26.76 mg/dl; reference: <1 mg/dl) with 89% neutrophilia. Chest X-rays and urine sediments were normal. A skin biopsy was performed showing intraluminal neutrophil thrombi in the deep dermis vessels, suggesting cutaneous septic embolism (Fig. 2).

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Dear Editor: Intravascular devices such as prosthetic vascular grafts are therapeutic tools of fundamental importance for patients with several vascular diseases... An 'erythematous plaque' eruption due to septic embolism from an infected prosthetic aortic graft is being reported... Clinical findings of cutaneous septic embolism are variable: palpable purpura, petechiae, hemorrhagic plaques, pustules, nodules, digital cyanosis and livedo reticularis have been described... Osler nodes and Janeway lesions are special forms of septic emboli presentations, commonly associated with bacterial endocarditis... On the other hand, erythematous plaques have been poorly described in the literature... Cutaneous septic embolism biopsy determines the presence of thrombus of neutrophil in dermal blood vessels, although bacteria are usually not detected... Once the diagnosis of infected emboli in patients carrying vascular devices is made, empiric broad-spectrum antibiotic therapy should start immediately... Our patient presented erythematous plaques due to infectious emboli with no evident of clinical signs of sepsis... Histopathology aids us to establish a diagnosis... Unfortunately, the patient died after the surgery... Erythematous plaques eruption should be taken into account as a clinical form of cutaneous septic emboli.

No MeSH data available.


Related in: MedlinePlus