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Ibrutinib-associated necrotic nasal lesion and pulmonary infiltrates
  1. Christopher Saling1,
  2. Fionna Feller2 and
  3. Holenarasipur R Vikram1
  1. 1Division of Infectious Diseases, Mayo Clinic, Phoenix, Arizona, USA
  2. 2Department of Internal Medicine, Mayo Clinic, Phoenix, Arizona, USA
  1. Correspondence to Dr Holenarasipur R Vikram;{at}


Herein, we report a case of a 68-year-old woman receiving ibrutinib for chronic lymphocytic leukaemia, who presented with septic shock and a progressive necrotic lesion on her nose. Surgical pathology of the nasal lesion revealed evidence of tissue necrosis, and both tissue and blood culture grew Pseudomonas aeruginosa. A diagnosis of ecthyma gangrenosum was made. Additional investigations also led to the discovery of invasive pulmonary aspergillosis. To our knowledge, this is the first case of ecthyma gangrenosum secondary to Pseudomonas sepsis and concurrent invasive pulmonary aspergillosis associated with ibrutinib use.

  • infectious diseases
  • malignant disease and immunosuppression
  • infections
  • dermatology

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  • Contributors CS, FF and HRV contributed to the planning, conduct, reporting and editing of this work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.