Ecthyma gangrenosum is an infective lesion of the skin and mucosal membranes. It forms either via bacterial hematogeneous spreading or a primary infection of the skin. It is most commonly caused by Pseudomonas aeruginosa. The most important risk factors are malignancy and neutropenia. However, ecthyma gangrenosum has rarely been reported in children that were previously healthy. In this case report we report a previously healthy 2 year old child presenting with ecthyma gangrenosum lesions after an ear infection. The child had no previous history of illness and a detailed immunulogical evaluation was normal We present this case to show that ecthyma gangrenosum may develop even in the absence of previous illness and in immunocompetent patients, but stress the importance of detailed evaluation.