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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| Format: | Article |
| Language: | English |
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American College of Physicians
2022-09-01
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| Series: | Annals of Internal Medicine: Clinical Cases |
| Online Access: | https://www.acpjournals.org/doi/10.7326/aimcc.2022.0240 |
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| _version_ | 1849698926512308224 |
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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. |
| format | Article |
| id | doaj-art-9e453fcdf6c94150a5828bee9d8a26f2 |
| institution | DOAJ |
| issn | 2767-7664 |
| language | English |
| publishDate | 2022-09-01 |
| publisher | American College of Physicians |
| record_format | Article |
| 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 |
| work_keys_str_mv | AT samikdoshi pyodermagangrenosummimickingnecrotizingfasciitisinamarathonrunnerwithmyelodysplasticsyndrome AT yunalee pyodermagangrenosummimickingnecrotizingfasciitisinamarathonrunnerwithmyelodysplasticsyndrome |