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Colostomy for perianal sepsis with ecthyma gangrenosum in immunocompromised children


Vuille-Dit-Bille, Raphael N; Berger, Christoph; Meuli, Martin; Grotzer, Michael A (2015). Colostomy for perianal sepsis with ecthyma gangrenosum in immunocompromised children. Journal of Pediatric Hematology/Oncology:1-5.

Abstract

BACKGROUND Perianal sepsis with ecthyma gangrenosum is a severe and potentially mutilating complication in immunocompromised children. Therapies include antimicrobial treatment, incision and drainage, generous tissue debridement, and skin transplantation. PROCEDURE We describe 3 children with acute lymphoblastic leukemia having sepsis with Pseudomonas aeruginosa in febrile neutropenia and severe perianal infections treated relatively early with a protective colostomy. Indications for colostomy were nonhealing wounds, and ceaseless pain. RESULTS All patients showed a rapid reduction of pain. Complete wound healing was seen in 2 patients, and considerable pain reduction and increased quality of life were seen in a third patient during palliative care. CONCLUSIONS These results suggest that a protective colostomy should be considered early in the management of immunocompromised children with ecthyma gangrenosum.

Abstract

BACKGROUND Perianal sepsis with ecthyma gangrenosum is a severe and potentially mutilating complication in immunocompromised children. Therapies include antimicrobial treatment, incision and drainage, generous tissue debridement, and skin transplantation. PROCEDURE We describe 3 children with acute lymphoblastic leukemia having sepsis with Pseudomonas aeruginosa in febrile neutropenia and severe perianal infections treated relatively early with a protective colostomy. Indications for colostomy were nonhealing wounds, and ceaseless pain. RESULTS All patients showed a rapid reduction of pain. Complete wound healing was seen in 2 patients, and considerable pain reduction and increased quality of life were seen in a third patient during palliative care. CONCLUSIONS These results suggest that a protective colostomy should be considered early in the management of immunocompromised children with ecthyma gangrenosum.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:6 March 2015
Deposited On:27 Nov 2015 07:33
Last Modified:05 Apr 2016 19:33
Publisher:Lippincott Williams & Wilkins
ISSN:1077-4114
Publisher DOI:https://doi.org/10.1097/MPH.0000000000000324
PubMed ID:25757025

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