Ecthyma Gangrenosum: A Rare Cutaneous Manifestation Caused by Stenotrophomonas maltophilia in a Leukemic Patient

Ecthyma gangrenosum (EG) is a well-recognized cutaneous infection that most commonly affects immunocompromised patients. It typically occurs on the extremities, or in gluteal and perineal regions. Although Pseudomonas aeruginosa is the most well-known pathogen causing EG, other organisms have been reported to cause EG. Herein we report a rare case of ecthyma gangrenosum presenting as aggressive necrotic skin lesions in perioral and infraorbital areas in a 47-year-old patient with acute myelocytic leukemia after allogeneic bone marrow transplantation. It was caused by Stenotropho-monas maltophilia, which is an aerobic, gram-negative pathogen that has been associated only rarely with cuta-neous disease. Blood culture and tissue culture were positive for S. maltophilia. Histological examination revealed numer-ous tiny bacilli in the dermis and perivascular area. Early rec-ognition of skin lesions caused by S. maltophilia is important to decrease associated mortality in immunosuppresse