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Atypical Cutaneous Manifestation of Mycosis Fungoides: A Case Report

Summary

A 68-year-old woman with mycosis fungoides, a rare skin cancer, developed severe infected lesions after swimming in the ocean. Her wounds were infected with four different types of bacteria that had not been previously reported together in this disease. She was treated with antibiotics and improved, highlighting the importance of patients with this condition avoiding water exposure and maintaining regular medical care.

Background

Mycosis fungoides (MF) is the most common cutaneous T-cell lymphoma, typically presenting with erythematous patches, plaques, and tumors. Various atypical presentations of MF have been described in the literature, and the skin microbiota is theorized to play a role in disease phenotypes.

Objective

To describe an unusual case of mycosis fungoides presenting with multiple large ulcerated and purulent lesions that developed after ocean water exposure, featuring a unique combination of bacterial superinfection organisms.

Results

Cultures from the largest lesion grew Morganelli morganii, Pseudomonas aeruginosa, Enterococcus avium, and Enterococcus faecalis – a combination not previously described. The patient was treated with IV vancomycin and IV piperacillin-tazobactam for 15 days with mild improvement.

Conclusion

This case highlights the importance of maintaining specialist follow-up, vigilant lesion monitoring, and avoiding environments that predispose MF patients to infection. It emphasizes the complexities of managing MF patients with concurrent bacterial infections involving uncommon pathogens and the critical importance of proper treatment strategies.
  • Published in:Cureus,
  • Study Type:Case Report,
  • Source: PMID: 39165452, DOI: 10.7759/cureus.65034
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