Ecthyma gangrenosum (EG) is a well-described skin lesion classically associated with Pseudomonas septicemia in immunocompromised patients, but may also be caused by other bacterial and fungal organisms [1]. The lesions characteristically appear as small indurated papulovesicles progressing rapidly to necrotic ulcers with surrounding erythema and a central black eschar [2]. Ecthyma gangrenosum is caused by invasion of microorganisms into the media and adventitia of subcutaneous vasculature, precipitating a hemorrhagic occlusive vasculitis [2,3]. Although rare, the presence of EG is indicative of severe systemic infection with a potentially fatal prognosis. Mortality rates for EG range from 15% to as high as 77% based on reports in the literature [4-11]. Factors that are associated with higher mortality include neutropenia, septic shock, inappropriate or delayed antibiotic therapy, and resistant microorganisms [1,7-12].

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