Colostomy for Perianal Sepsis With Ecthyma Gangrenosum in Immunocompromised Children.


BACKGROUND Perianal sepsis with ecthyma gangrenosum is a severe and potentially mutilating complication in immunocompromised children. Therapies include antimicrobial treatment, incision and drainage, generous tissue debridement, and skin transplantation. PROCEDURE We describe 3 children with acute lymphoblastic leukemia having sepsis with Pseudomonas aeruginosa in febrile neutropenia and severe perianal infections treated relatively early with a protective colostomy. Indications for colostomy were nonhealing wounds, and ceaseless pain. RESULTS All patients showed a rapid reduction of pain. Complete wound healing was seen in 2 patients, and considerable pain reduction and increased quality of life were seen in a third patient during palliative care. CONCLUSIONS These results suggest that a protective colostomy should be considered early in the management of immunocompromised children with ecthyma gangrenosum.

DOI: 10.1097/MPH.0000000000000324

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@article{VuilleditBille2016ColostomyFP, title={Colostomy for Perianal Sepsis With Ecthyma Gangrenosum in Immunocompromised Children.}, author={Raphael Nicolas Vuille-dit-Bille and Christoph T Berger and Martin Meuli and Michael Andreas Grotzer}, journal={Journal of pediatric hematology/oncology}, year={2016}, volume={38 1}, pages={53-7} }