Stavros Liatis

Pseudomonas luteola cutaneous abscess and bacteraemia in a previously healthy man.

Pseudomonas luteola is uncommonly implicated in clinical infections, but it constitutes a significant nosocomial pathogen causing mainly infections associated with foreign material. This report describes an unusual case of a Pseudomonas luteola strain that infected and caused cutaneous abscess and bacteraemia in a previously healthy man.

Stenotrophomonas maltophilia: a serious and rare complication in patients suffering from burns

Stenotrophomonas maltophilia is rarely implicated in clinical infections but it constitutes a significant nosocomial pathogen, especially in immunocompromised patients. This report describes the first case of a generalised infection caused by S. maltophilia that included bacteremia, wound and respiratory tract infection in a patient suffering from burns. Given the emergence of S. maltophilia nosocomial infections, especially in patients with burns, isolation of the bacterium from blood cultures should prompt the commencement of adequate antibiotic treatment.

Pseudomonas fluorescens cutaneous abscess and recurrent bacteremia following a dog bite

A 65-year-old White man was examined in our outpatient clinic. Fifteen months ago, at the end of spring, he noticed a pruritic eruption, which was more intense on his sun-exposed skin. He did not use any continuous medication or fragances. Skin examination showed erythema with edema and scaling on the face (Fig. 1a), neck (Fig. 2a), forearms and dorsum of the hands. On his neck a clear demarcation between the exposed and the protected skin could be seen. Lymph nodes were of normal size. Light microscopy showed a eczematous dermatitis, without epidermal microabcesses or an interface dermatitis. Phototesting with UVA was able to reproduce the eruption on his back. Internal investigation ruled out visceral or lymph node enlargement. Serology for autoimmune diseases was negative. He was initially treated with systemic and topical steroids, associated with high-protection sunscreens, which improved his skin only slightly. Dihydroxycloroquine 250 mg a day was also prescribed and was ineffective. Before using systemic immunosuppressors, such as azathioprine, topical 1% pimecrolimus was prescribed twice daily associated with a potent sunscreen. This therapy controlled the disease (Figs 1b and 2b). After 3 weeks the desquamation and the edema disappeared; topical pimecrolimus was then reduced to once a day. After a further 4 weeks the treatment was reduced again to three applications a week, and maintained at this level until the end of autumn (the southern region of Brazil has a temperate climate with four well-defined seasons). Pimecrolimus is a macrolide with immunosuppressive properties, whose topical use is effective in inhibiting T-lymphocyte activity. Together with tacrolimus, the other approved substance in this group, pimecrolimus ushers in a new era in dermatological therapy, replacing in some situations corticosteroid treatment. These drugs are effective in atopic and allergic contact dermatitis, conditions mediated by T lymphocytes. The treatment of chronic actinic dermatitis is sometimes disappointing, and frequently complex systemic therapy with potential side-effects must be used. 3–5