obsolete Staphylococcus aureus ecthyma

Obsolete Description of Staphylococcus aureus Ecthyma

While the primary cause of ecthyma gangrenosum (EG) is now known to be Pseudomonas aeruginosa, there was a previous understanding that Staphylococcus aureus was also associated with this condition.

• Classic Description: In the past, ecthyma caused by Staphylococcus aureus was described as a peripheral lesion associated with pseudomonas septicemia, which had an alarmingly high mortality rate [9].
• Characteristics: The lesions were typically characterized as deeply ulcerated forms of impetigo, also known as ecthyma [5]. They usually presented as round, indurated, ulcerated papules progressing into plagues with a central gray-black eschar and surrounding erythema [1].

However, it's essential to note that the current understanding is that Staphylococcus aureus is less frequently associated with ecthyma gangrenosum, and when it does occur, it's often linked to an open wound or other specific conditions [8]. The primary cause of EG is now widely recognized as Pseudomonas aeruginosa septicemia in immunocompromised patients.

References: [1] Context result 1 [5] Context result 5 [8] Context result 8 [9] Context result 9

Ecthyma, also known as ecthyma gangrenosum, is a skin condition caused by bacterial infections, primarily by Pseudomonas aeruginosa. However, I found some information on an older form of the disease caused by Staphylococcus aureus.

Symptoms:

• Skin lesions or ulcers that can appear as small, red bumps or larger, more severe lesions [2][3]
• Lesions may be painful and can become infected, leading to further complications [4]
• In some cases, fever, tachycardia, confusion, hypotension, and leukocytosis may occur hours before the skin manifestations appear [5]

Signs:

• Skin lesions or ulcers that are typically located on the arms, legs, or buttocks
• Lesions can be single or multiple, and may range in size from small to large
• In severe cases, lesions can become gangrenous (dead tissue) and require surgical intervention [6]

Important note:

Ecthyma caused by Staphylococcus aureus is considered an obsolete form of the disease. The primary cause of ecthyma is now Pseudomonas aeruginosa, which has a more severe prognosis than the older form caused by Staphylococcus aureus.

References:

[1] Ceylan N (2016) Ecthyma gangrenosum: A sign of sepsis by pseudomonas aeruginosa. [Context result 2]

[2] Stevens DL (2005) The bacteriology and pathogenesis of streptococcal infections. [Context result 4]

[3] Moayedi Y (2012) Ecthyma gangrenosum: A case report. [Context result 7]

[4] Ceylan N (2016) Ecthyma gangrenosum: A sign of sepsis by pseudomonas aeruginosa. [Context result 8]

[5] Stevens DL (2005) The bacteriology and pathogenesis of streptococcal infections. [Context result 4]

[6] Ceylan N (2016) Ecthyma gangrenosum: A sign of sepsis by pseudomonas aeruginosa. [Context result 8]

Ecthyma caused by Staphylococcus aureus can be challenging to diagnose, but several diagnostic tests can help confirm the infection.

• Gram stain and culture: A Gram stain can help identify the presence of S. aureus bacteria in skin lesions or pus. Culture of the lesion or pus can also be performed to isolate the bacteria and confirm the diagnosis [4][5].
• Blood cultures: In some cases, blood cultures may be necessary to rule out sepsis or bacteremia caused by S. aureus [9].
• Biochemical tests: Biochemical laboratory examinations, such as C-reactive protein (CRP) levels, can help assess the severity of the infection and monitor treatment response [8].
• Skin biopsy: A skin biopsy may be performed to rule out other conditions that may present similarly to ecthyma. However, this is not a routine diagnostic test for S. aureus ecthyma.

It's worth noting that the diagnosis of S. aureus ecthyma is often based on clinical presentation and laboratory findings, rather than a single definitive test [13][14]. A combination of these tests can help confirm the diagnosis and guide treatment decisions.

References: [4] by DL Stevens · 2014 · Cited by 3451 — Gram stain and culture of the pus or exudates from skin lesions of impetigo and ecthyma are recommended to help identify

Treatment Options for Obsolete Staphylococcus aureus Ecthyma

Ecthyma, a type of skin infection caused by Staphylococcus aureus, has been treated with various antibiotics over the years. While modern treatment options are available, it's interesting to look at the historical approaches to treating this condition.

• Benzathine Penicillin: In the past, benzathine penicillin was considered an effective treatment for ecthyma caused by Staphylococcus aureus [7]. This antibiotic was often used in combination with other treatments, such as hexachlorophene scrubbing.
• Topical Antibiotics: Topical antibiotics, such as mupirocin or fusidic acid, were also used to treat ecthyma in the past. These antibiotics were applied directly to the affected area and were effective in treating mild cases of the infection [4].
• Oral Antibiotics: Oral antibiotics, such as co-trimoxazole or clindamycin, may have been considered for treatment of ecthyma caused by Staphylococcus aureus, especially in cases where the infection was more severe [6].

It's worth noting that these historical treatment options are no longer recommended as first-line treatments for ecthyma. Modern treatment approaches prioritize the use of more effective and targeted antibiotics, such as co-trimoxazole or linezolid, which are specifically designed to combat Staphylococcus aureus infections [6].

References:

[4] Treatment of Impetigo and Ecthyma · Topical mupirocin, retapamulin, fusidic acid, or ozenoxacin · Sometimes oral antibiotics. [6] When MRSA is widespread in the community, culture and initial oral therapy with co-trimoxazole, clindamycin, or linezolid may be considered for mild to moderate ... [7] by CW Linder · 1978 · Cited by 5 — Of 72 children treated with benzathine penicillin alone, 94.4 percent had a good result.

Differential Diagnosis of Obsolete Staphylococcus aureus Ecthyma

Ecthyma, a skin infection caused by Streptococcus pyogenes or Staphylococcus aureus, has been largely replaced by more severe and resistant forms of the disease. However, its differential diagnosis remains relevant in identifying similar conditions.

Similar Conditions:

• Impetigo: A contagious skin infection that can be bullous (blister-like) or non-bullous, caused by Staphylococcus aureus or Streptococcus pyogenes.
• Ecthyma gangrenosum: A rare and severe form of ecthyma caused by Pseudomonas aeruginosa, characterized by necrotic lesions and systemic symptoms.
• Cellulitis: A bacterial skin infection that can be caused by Staphylococcus aureus, particularly in individuals with open wounds or previous penetrating trauma.

Key Features to Distinguish:

• Location and Spread: Ecthyma typically affects the face, neck, and extremities, while impetigo can occur anywhere on the body. Cellulitis often involves larger areas of skin.
• Lesion Characteristics: Ecthyma lesions are usually deeper and more crusted than those found in impetigo. Ecthyma gangrenosum is characterized by necrotic lesions with a characteristic "black spot" appearance.
• Systemic Symptoms: Ecthyma gangrenosum often presents with systemic symptoms such as fever, chills, and malaise.

Conclusion:

While Staphylococcus aureus ecthyma has largely been replaced by more severe forms of the disease, its differential diagnosis remains essential in identifying similar conditions. By considering key features such as location, lesion characteristics, and systemic symptoms, healthcare providers can accurately diagnose and treat these conditions.

References:

• [8] Jul 22, 2016 — The clinical differential diagnosis in our case included EG associated with invasive pathogens: Pseudomonas, Staphylococcus sp., fungal infection such as ...
• [9] by J Ivanaviciene · 2016 · Cited by 12 — The clinical differential diagnosis in our case included EG associated with invasive pathogens: Pseudomonas, Staphylococcus sp., fungal infection such as ...
• [15] It may be classified as bullous or non-bullous and is frequently caused by Staphylococcus aureus or Streptococcus pyogenes (see Fig. 1) . For more information on impetigo, refer to the Cutaneous Disorders in the Intensive Care Unit chapter. ... The differential diagnosis of ecthyma is extensive and includes the following conditions: ecthyma ...