A Case of Pyoderma Gangrenosum Misdiagnosed as Necrotizing Infection: A Potential Diagnostic Catastrophe

In this article, we present a case of pyoderma gangrenosum (PG), misdiagnosed initially as a necrotizing infection that significantly worsened due to repeated surgical debridement and aggressive wound care therapy, almost resulting in limb amputation despite antibiotic therapy. The PG lesions improv...

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Main Authors: Medina G. Saffie, Anjali Shroff
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Case Reports in Infectious Diseases
Online Access:http://dx.doi.org/10.1155/2018/8907542
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author Medina G. Saffie
Anjali Shroff
author_facet Medina G. Saffie
Anjali Shroff
author_sort Medina G. Saffie
collection DOAJ
description In this article, we present a case of pyoderma gangrenosum (PG), misdiagnosed initially as a necrotizing infection that significantly worsened due to repeated surgical debridement and aggressive wound care therapy, almost resulting in limb amputation despite antibiotic therapy. The PG lesions improved after pancytopenia were further investigated, and the diagnosis and treatment of an underlying hematologic malignancy was initiated. The diagnosis and management of PG is challenging given the paucity of robust clinical evidence, lack of standard diagnostic criteria, and absence of clinical practice guidelines. It is imperative that clinicians recognize PG as a clinical diagnosis that must be considered in any patient with enlarging, sterile, necrotic lesions that are unresponsive to prolonged and appropriate antibiotics. Early recognition can prevent devastating sequelae such as deep tissue and bone infections associated with a chronic open wound, severe cosmetic morbidity, and potential limb amputation.
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spelling doaj-art-0e6db7bf95354d7e918fada08eee562b2025-08-20T03:17:19ZengWileyCase Reports in Infectious Diseases2090-66252090-66332018-01-01201810.1155/2018/89075428907542A Case of Pyoderma Gangrenosum Misdiagnosed as Necrotizing Infection: A Potential Diagnostic CatastropheMedina G. Saffie0Anjali Shroff1Department of Infectious Diseases Post Graduate Training Program, McMaster University, Hamilton, ON, CanadaDepartment of Infectious Diseases, McMaster University, Hamilton, ON, CanadaIn this article, we present a case of pyoderma gangrenosum (PG), misdiagnosed initially as a necrotizing infection that significantly worsened due to repeated surgical debridement and aggressive wound care therapy, almost resulting in limb amputation despite antibiotic therapy. The PG lesions improved after pancytopenia were further investigated, and the diagnosis and treatment of an underlying hematologic malignancy was initiated. The diagnosis and management of PG is challenging given the paucity of robust clinical evidence, lack of standard diagnostic criteria, and absence of clinical practice guidelines. It is imperative that clinicians recognize PG as a clinical diagnosis that must be considered in any patient with enlarging, sterile, necrotic lesions that are unresponsive to prolonged and appropriate antibiotics. Early recognition can prevent devastating sequelae such as deep tissue and bone infections associated with a chronic open wound, severe cosmetic morbidity, and potential limb amputation.http://dx.doi.org/10.1155/2018/8907542
spellingShingle Medina G. Saffie
Anjali Shroff
A Case of Pyoderma Gangrenosum Misdiagnosed as Necrotizing Infection: A Potential Diagnostic Catastrophe
Case Reports in Infectious Diseases
title A Case of Pyoderma Gangrenosum Misdiagnosed as Necrotizing Infection: A Potential Diagnostic Catastrophe
title_full A Case of Pyoderma Gangrenosum Misdiagnosed as Necrotizing Infection: A Potential Diagnostic Catastrophe
title_fullStr A Case of Pyoderma Gangrenosum Misdiagnosed as Necrotizing Infection: A Potential Diagnostic Catastrophe
title_full_unstemmed A Case of Pyoderma Gangrenosum Misdiagnosed as Necrotizing Infection: A Potential Diagnostic Catastrophe
title_short A Case of Pyoderma Gangrenosum Misdiagnosed as Necrotizing Infection: A Potential Diagnostic Catastrophe
title_sort case of pyoderma gangrenosum misdiagnosed as necrotizing infection a potential diagnostic catastrophe
url http://dx.doi.org/10.1155/2018/8907542
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