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The International Journal of Lower Extremity Wounds
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A Case Report of the Eradication of Pseudomonas aeruginosa from Leg Ulcer in a Patient with Essential Thrombocythemia

Vincenzo Savini, MD

Clinical Microbiology and Virology Unit, Department of Transfusion Medicine, Spirito Santo Hospital, (Pe) Pescara Italy, vincsavi{at}yahoo.it

Chiara Catavitello

Clinical Microbiology and Virology Unit, Department of Transfusion Medicine, Spirito Santo Hospital, (Pe) Pescara Italy

Azaira Bianco

Clinical Microbiology and Virology Unit, Department of Transfusion Medicine, Spirito Santo Hospital, (Pe) Pescara Italy

Andrea Balbinot

Clinical Microbiology and Virology Unit, Department of Transfusion Medicine, Spirito Santo Hospital, (Pe) Pescara Italy

Domenico D'Antonio, MD

Clinical Microbiology and Virology Unit, Department of Transfusion Medicine, Spirito Santo Hospital, (Pe) Pescara Italy

A patient treated with hydroxyurea had a lower extremity ulcer that was found infected with Pseudomonas aeruginosa. Drug discontinuation and ceftazidime treatment did not initially lead to resolution due to misidentification of inducible betalactamases expressed by the organism and subsequent clinical failure of the cephalosporin in eradicating infection. These class C enzymes may be strongly induced after betalactam exposure and confer resistance to penicillins, cephalosporins, betalactamase inhibitors but not to carbapenems. Though hydroxyurea represents a major cause of essential thrombocythemia-related ulcers, lesion infections by difficult-to-treat organisms should be eradicated to promote wound healing.

Key Words: Pseudomonas aeruginosa • essential thrombocythemia • hydroxyurea • inducible betalactamases

The International Journal of Lower Extremity Wounds, Vol. 8, No. 2, 117-119 (2009)
DOI: 10.1177/1534734609334811
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