• Stephanie Biscaye, Diane Demonchy, Mickael Afanetti, Audrey Dupont, Herve Haas, and Antoine Tran.
• Pediatric Hospitals of Nice CHU-Lenval, Nice, France.
• Medicine (Baltimore). 2017 Jan 1; 96 (2): e5507.

RationaleEcthyma gangrenosum (Eg) is a necrotic lesion that is mostly seen in immunocompromised patients. It reflects a severe sepsis, possibly caused by Pseudomonas aeruginosa (Pa).Patient ConcernsA healthy 3-year-old girl admitted to the Pediatric Emergency Department presented a sepsis-associated purpura with neurological and respiratory distress.InterventionsAn empiric antibiotherapy (anti-meningococcal) was prescribed.DiagnosesForty-eight hours after admission, blood and wound cultures were positive for Pa. As a result, the decision was made to change the antibiotic therapy.Unfortunately, on day 3, the patient died. Exhaustive immunologic tests are presently being carried out.OutcomesEg caused by Pa is uncommon in healthy children, and purpura sepsis is usually caused by Neisseria meningitides infection.LessonsEg should be recognized rapidly so that the appropriate treatment can be prescribed as quickly as possible.

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