Gangrene of the genitalia in children with pseudomonas sepsis.

The incidence of Pseudomonas aeruginosa bacteremia is increasing. Successful management is based upon early and aggressive therapy of the bacteremia and the usually associated granulocytopenia. A small number of such patients present with ecthyma gangrenosum, a characteristic skin lesion. During the last 4 years 5 children with acute leukemia and granulocytopenia presented to our hospital with these lesions. Although they occur most frequently on the extremities, buttocks or perineal region 2 of our patients had only isolated lesions of the external genitalia, resulting in gangrene of the penis in 1 and gangrene of the labia majora in the other. The gross and histologic pathology is reviewed. Recognition of this characteristic skin lesion enables the prompt institution of appropriate therapy.