Pyoderma Gangrenosum Mimicking Necrotizing Fasciitis in a Marathon Runner With Myelodysplastic Syndrome

A 62-year-old man with myelodysplastic syndrome presented with fever, leukocytosis, and a violaceous lesion on his right leg. His skin lesion worsened, and his fever persisted despite him receiving broad-spectrum antibiotics and multiple surgical debridements for a presumptive diagnosis of necrotizi...

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Main Authors: Samik Doshi, Yuna Lee
Format: Article
Language:English
Published: American College of Physicians 2022-09-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2022.0240
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author Samik Doshi
Yuna Lee
author_facet Samik Doshi
Yuna Lee
author_sort Samik Doshi
collection DOAJ
description A 62-year-old man with myelodysplastic syndrome presented with fever, leukocytosis, and a violaceous lesion on his right leg. His skin lesion worsened, and his fever persisted despite him receiving broad-spectrum antibiotics and multiple surgical debridements for a presumptive diagnosis of necrotizing fasciitis. Through careful review of histopathologic findings and his clinical presentation, he was subsequently diagnosed with pyoderma gangrenosum (PG). This case highlights an important diagnostic challenge. PG should be suspected in cases of nonresolving soft-tissue infection, particularly in the context of associated systemic disease, negative microbiological results, and negative work-up for autoimmune and malignant conditions.
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series Annals of Internal Medicine: Clinical Cases
spelling doaj-art-9e453fcdf6c94150a5828bee9d8a26f22025-08-20T03:18:45ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642022-09-011710.7326/aimcc.2022.0240Pyoderma Gangrenosum Mimicking Necrotizing Fasciitis in a Marathon Runner With Myelodysplastic SyndromeSamik Doshi0Yuna Lee11Department of Medicine, University of Toronto, Toronto, Ontario, Canada1Department of Medicine, University of Toronto, Toronto, Ontario, CanadaA 62-year-old man with myelodysplastic syndrome presented with fever, leukocytosis, and a violaceous lesion on his right leg. His skin lesion worsened, and his fever persisted despite him receiving broad-spectrum antibiotics and multiple surgical debridements for a presumptive diagnosis of necrotizing fasciitis. Through careful review of histopathologic findings and his clinical presentation, he was subsequently diagnosed with pyoderma gangrenosum (PG). This case highlights an important diagnostic challenge. PG should be suspected in cases of nonresolving soft-tissue infection, particularly in the context of associated systemic disease, negative microbiological results, and negative work-up for autoimmune and malignant conditions.https://www.acpjournals.org/doi/10.7326/aimcc.2022.0240
spellingShingle Samik Doshi
Yuna Lee
Pyoderma Gangrenosum Mimicking Necrotizing Fasciitis in a Marathon Runner With Myelodysplastic Syndrome
Annals of Internal Medicine: Clinical Cases
title Pyoderma Gangrenosum Mimicking Necrotizing Fasciitis in a Marathon Runner With Myelodysplastic Syndrome
title_full Pyoderma Gangrenosum Mimicking Necrotizing Fasciitis in a Marathon Runner With Myelodysplastic Syndrome
title_fullStr Pyoderma Gangrenosum Mimicking Necrotizing Fasciitis in a Marathon Runner With Myelodysplastic Syndrome
title_full_unstemmed Pyoderma Gangrenosum Mimicking Necrotizing Fasciitis in a Marathon Runner With Myelodysplastic Syndrome
title_short Pyoderma Gangrenosum Mimicking Necrotizing Fasciitis in a Marathon Runner With Myelodysplastic Syndrome
title_sort pyoderma gangrenosum mimicking necrotizing fasciitis in a marathon runner with myelodysplastic syndrome
url https://www.acpjournals.org/doi/10.7326/aimcc.2022.0240
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AT yunalee pyodermagangrenosummimickingnecrotizingfasciitisinamarathonrunnerwithmyelodysplasticsyndrome