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Cutaneous infection caused by Serratia marcescens in a child

2006; Elsevier BV; Volume: 55; Issue: 2 Linguagem: Inglês

10.1016/j.jaad.2005.08.053

1097-6787

Fernando Rodríguez García, Roberto C. Paz, Rosalba S. González, Eduardo S. Ruiz, F.G. Martín-Neda, Miguel S. Rodríguez, Marina R. Martín, Miriam Sidro Sarto, Hugo A. Arguelles, Marta García Bustínduy, Antonio N. Cabrera,

Bacterial Identification and Susceptibility Testing

decreased sweating, and slight decreased colony number on the affected side; S albus, S aureus, and Bacillus subtilis were isolated from both sides.Histologic examination was not performed.Interestingly, when the patient's numbness resolved, her SD did as well.Pathogenesis of SD remains unknown, but it is postulated to be multifactorial and involve genetic predisposition, Malassezia species, and dysregulation of immune, sebaceous, and/or neurologic pathways. 4 The lack of therapeutic response in our patient is most likely a result of our inability to correct his ipsilateral neurologic deficit.In the original case report, the unilateral SD and ipsilateral numbness resolved concurrently, supporting this hypothesis.This intimate relationship among the genetically predisposed epidermis, sebaceous glands, and milieu (immune, neurologic, micro-organisms) is clearly demonstrated with this unusual presentation of SD.This may also explain why other patients with neurocutaneous disease, such as SD in patients with Parkinson's and HIV, may inadequately respond to conventional therapy.This unusual presentation supports a neurocutaneous mechanism that may involve the sebaceous and immune pathways.Sebaceous differentiation and nerve density has not been reported in patients with Parkinson's and HIV along with SD.A systematic evaluation of these parameters in this unique subset of patients may further elucidate SD multifactorial pathogenesis.