Pyoderma gangrenosum or necrotising fasciitis? Diagnostic and therapeutic wanderings

Abstract A case of post-traumatic lower-limb pyoderma gangrenosum (PG) in a 77-year-old female is reported. The diagnosis of PG is frequently one of exclusion, and it is therefore unsurprising that the condition was initially mistaken for necrotising fasciitis then for necrotising bacterial dermo-hy...

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Published in:Orthopaedics & traumatology, surgery & research surgery & research, 2017-06, Vol.103 (4), p.615-617
Main Authors: Vaysse-Vic, M, Mathieu, P.-A, Charissoux, A, Charissoux, J.-L, Marcheix, P.-S
Format: Article
Language:English
Subjects:
Accidents, Traffic
Aged
Amoxicillin - administration & dosage
Amoxicillin - therapeutic use
Anti-Bacterial Agents - administration & dosage
Anti-Bacterial Agents - therapeutic use
Clavulanic Acid - administration & dosage
Clavulanic Acid - therapeutic use
Diagnosis
Diagnosis, Differential
Fasciitis, Necrotizing - diagnosis
Female
Humans
Leg
Leg Injuries - complications
Leg Injuries - surgery
Lower Extremity
Orthopedics
Pyoderma gangrenosum
Pyoderma Gangrenosum - complications
Pyoderma Gangrenosum - diagnosis
Pyoderma Gangrenosum - therapy
Reconstructive Surgical Procedures
Skin diseases
Surgery
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Summary:Abstract A case of post-traumatic lower-limb pyoderma gangrenosum (PG) in a 77-year-old female is reported. The diagnosis of PG is frequently one of exclusion, and it is therefore unsurprising that the condition was initially mistaken for necrotising fasciitis then for necrotising bacterial dermo-hypodermitis. Medical and surgical treatment for those conditions proved ineffective. This fact, together with the atypical presentation, promoted a re-evaluation of the diagnosis. The clinical findings and investigation results converged to suggest PG, and a therapeutic trial was initiated. The good treatment response and negative findings from tests for other conditions established the diagnosis of post-traumatic PG.
ISSN:1877-0568
1877-0568
DOI:10.1016/j.otsr.2017.01.009