{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T18:54:20Z","timestamp":1768416860654,"version":"3.49.0"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Ecthyma gangrenosum (EG) is a distinctive cutaneous marker of\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      (\n                      <jats:italic>P. aeruginosa<\/jats:italic>\n                      ) bacteremia, particularly in neutropenic hosts. In infants, community-acquired\n                      <jats:italic>P. aeruginosa<\/jats:italic>\n                      infection can precipitate fulminant septic shock with high mortality, underscoring the importance of early EG recognition.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      We report a 4-month-old ex-preterm girl presenting with fever, lethargy, and feeding intolerance. Investigations revealed profound neutropenia (ANC 0.08\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L), markedly elevated inflammatory markers, and a violaceous perianal plaque. Within 24\u2005h, the lesion progressed to necrotic ulceration with septic shock. Blood and wound cultures confirmed\n                      <jats:italic>P. aeruginosa<\/jats:italic>\n                      . Management included meropenem therapy, continuous renal replacement for cytokine storm, intravenous immunoglobulin, and urgent surgical debridement, resulting in clinical stabilization and wound improvement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      EG is an early sentinel sign of community-acquired\n                      <jats:italic>P. aeruginosa<\/jats:italic>\n                      bacteremia in neutropenic infants. Careful perianal and genital examination is essential in febrile neutropenia, and prompt initiation of anti-pseudomonal therapy with timely source control is critical to reduce mortality.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2025.1709166","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T06:30:31Z","timestamp":1764225031000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Community-acquired Pseudomonas aeruginosa sepsis presenting with ecthyma gangrenosum in a neutropenic infant: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Xing","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongmei","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ting","family":"Ge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ting","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaolu","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1128\/jb.178.1.85-93.1996","article-title":"Comparative genome mapping of Pseudomonas aeruginosa PAO with P. aeruginosa C, which belongs to a major clone in cystic fibrosis 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