SEPTIC SHOCK AND SOFT TISSUE LESIONS IN PSEUDOMONAS AERUGINOSA BACTERAEMIA IN PAEDIATRIC HAEMATO-/ONKOLOGIC PATIENTS - A RETROSPECTIVE ANALYSIS
9 slide(s) – English – 2011-06-07
Background and aims
Pseudomonas aeruginosa (Pa) causes difficult-to-treat nosocomial infections in neutropenic patients including sepsis and soft tissue defects (ecthyma gangraenosum, necrotising fasciitis, perityphlitic abscess). We describe a single center experience of Pa infections, complicated by soft tissue lesions in paediatric haemato-/oncologic patients.
At the Division of Paediatric Haematology/Oncology of the Medical University of Graz, Austria, we retrospectively analysed blood cultrure (BC) results from the years 1999 through 2010. Frequency and clinical course of Pa bacteraeimas were analyzed.
From 1999 through 2010 a total of 3376 blood cultures (BC) were drawn. In 190/3376 (5,6%) BC a pathogen was isolated. In 18/190 (9,4%) BC Pa was detected. 17/18 patients with Pa bacteriaemia developed septic shock. Five out of 18 (27,8%) patients had septic shock combined with soft tissue complications (2x ecthyma gangraenosum, 1x necrotizing fasciitis, 1x perityphlitic abscess , 1x inflamed hemorrhoids), of whom 3 patients required surgical interventions (1x incision and drainage combined with temporary colostomy, 1x vacuum assisted closure dressing, 1x incision,)
Pa-associated bacteraemias are life-threatening complications in immunocompromised patients. Soft tissue lesions are dreaded complications. In addition to antibiotic therapy and G-CSF-application, surgical intervention is frequently required in complicated courses.