Background: To evaluate whether histopathologic findings of skin in sepsis by Pseudomonas aeruginosa correlate with the clinical course. Methods: Histological alterations after bacterial challenge by one susceptible (A) and two multidrug-resistant isolates (B and C) of P. aeruginosa were studied in 18 rabbits. Sepsis was induced by the intravenous infusion of 1 × 108 CFU by a catheter in the right jugular vein; blood was sampled for the estimation of tumor necrosis factor α (TNF-α) and malondialdehyde (MDA). Skin biopsies were collected along with a subcutaneous fat specimen for culture. Results: The mean survival was 0.85, 1.75 and 11.00 days after challenge by isolates A, B and C, respectively. The main histologic findings of skin were: inflammation and swelling of the dermis; thickening of the endothelium and infiltration of vessel wall and lumen by polymorphonuclear leukocytes; extravasation of red blood cells, and necrobiotic changes of the hair follicles. Serum TNF-α was elevated in animals challenged by isolate A compared to challenge by isolates B and C. Concentrations of MDA were similar for all isolates. Mean log10 of viable cells isolated from subcutaneous fat were 5.74, 2.74 and 1.40 after challenge by isolates A, B and C, respectively. Conclusions: Prolongation of survival was accompanied by lower serum TNF-α, decreased viable cells from subcutaneous fat and intensified inflammatory response in the dermis and subcutaneous tissue. These findings might be of importance for immunomodulatory intervention.

Keywords:
Sepsis, Rabbits, Pseudomonas aeruginosa, Virulence, Early cutaneous alterations
1.
Sangeorzan JA, Bradley JF, Kauffman CA: Cutaneous manifestations of Pseudomonas infection in the acquired immunodeficiency syndrome. Arch Dermatol 1990;126:832–833.
2.
Siegman-Igra Y, Ravona R, Primerman H, Giladi M: Pseudomonas aeruginosa bacteremia: An analysis of 123 episodes, with particular emphasis on the effect of antibiotic therapy. Int J Infect Dis 1980;2:211–215.
3.
Rangel Frausto MS: The epidemiology of bacterial sepsis. Infect Dis Clin North Am 1999;13:299–311.
4.
Engelhard D, Pomernz S, Gallily S, Strauss N, Tuomanen E: Serotype-related differences in inflammatory response to Streptococcus pneumoniae in experimental meningitis. J Infect Dis 1997;175:979–982.
5.
Giamarellos-Bourboulis EJ, Grecka P, Dionyssiou-Asteriou A, Giamarellou H: In vitro activity of polyunsaturated fatty acids on Pseudomonas aeruginosa: Relationship to lipid peroxidation. Prostaglandins Leukot Essent Fatty Acids 1998;58:283–287.
6.
Muzio G, Salvo RA, Trombetta A, et al: Dose-dependent inhibition of cell proliferation induced by lipid peroxidation products in rat hepatoma cells after enrichment with arachidonic acid. Lipids 1999;34:705–711.
7.
Sangeorzan JA, Bradley JF, Kauffman CA: Cutaneous manifestations of Pseudomonas infection in the acquired immunodeficiency syndrome. Arch Dermatol 1990;126:832–833.
8.
Rolston KV, Bodey GP: Pseudomonas aeruginosa infection in cancer patients. Cancer Invest 1999;10:43–59.
9.
Flores G, Stavola JJ, Noel GJ: Bacteremia due to Pseudomonas aeruginosa in children with AIDS. Clin Infect Dis 1993;16:706–708.
10.
Garcia-Patos V, Castells A: Infecciones cutaneas por Pseudomonas aeruginosa. Piel 1995;10:87–98.
11.
Silvestre JF, Betlloch MI: Cutaneous manifestations due to Pseudomonas infection. Int J Dermatol 1999;38:419–431.
12.
Musher DM: Cutaneous manifestations of bacterial sepsis. Hosp Pract 1989;24:71–75.
13.
Watanakunakorn C: Multiple painful indurated erythematous nodular skin lesions associated with Pseudomonas aeruginosa septicemia. Clin Infect Dis 1998;27:662–663.
14.
Schlossberg D: Multiple erythematous nodules as a manifestation of Pseudomonas aeruginosa septicemia. Arch Dermatol 1980;116:446–447.
15.
Greene SL, Su WPD, Muller SA: Pseudomonas aeruginosa infections of the skin. Am Phys Pract 1984;29:193–200.
16.
Greene SL, Su WPD, Muller SA: Ecthyma gangrenosum: Report of clinical, histopathologic, and bacteriologic aspects of eight cases. J Am Acad Dermatol 1984;11:781–787.
© 2004 S. Karger AG, Basel
2004
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.