Introduction:
Ecthyma gangrenosum is known as a characteristic lesion of Pseudomonas aeruginosa sepsis and is usually seen in immunocompromised patients.
Case presentation:
A previously healthy 63-year-old man was admitted with sloughy necrotic ulcerations of the skin over his sternum. He was afebrile and in good condition. A skin biopsy revealed ecthyma gangrenosum. Blood cultures remained sterile, but a culture of biopsy material grew Pseudomonas aeruginosa.
Conclusion:
Ecthyma gangrenosum may develop even in the absence of bacteremia and even in immunocompetent patients. It should be considered as a possible diagnosis even when a previously healthy patient has negative blood cultures.