An Unusual Presentation of Nonpseudomonal Ecthyma Gangrenosum of the Oral Cavity from Oropharyngeal Bacterial Species in an Immunosuppressed Patient

Ecthyma gangrenosum (EG) is a necrotizing skin lesion that typically begins as an erythematous or hemorrhagic area and progresses to a necrotic ulcer with a black eschar. EG is most commonly associated with Pseudomonas aeruginosa infections in immunocompromised individuals, though other pathogens have been implicated in rare cases. We present an unusual case of EG originating in the oral cavity of an immunosuppressed patient, accompanied by extensive ecchymoses and polymicrobial infection, notably without P. aeruginosa involvement. This report highlights the atypical clinical and pathologic features of the case and reviews the broader spectrum of microorganisms associated with EG.