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Untreatable Surgical Site Infection: Consider Pyoderma Gangrenosum

Berlinrut, Ilan MD*†; Bhatia, Nitasha MD*†; Josse, Jonathan M. MD, MSc†§; de Vinck, David DO‡§; Kaul, Sanjeev MD†§

Plastic and Reconstructive Surgery – Global Open: June 2014 - Volume 2 - Issue 6 - p e166
doi: 10.1097/GOX.0000000000000114
Case Reports
United States

Summary: Pyoderma gangrenosum (PG) is an inflammatory disease characterized by sterile infiltration of the skin by neutrophils. We describe a case of a 63-year-old woman who developed PG following an abdominal wall reconstruction. Her initial presentation was thought to be consistent with a surgical site infection. Antibiotic therapy was initiated, and the patient was taken for multiple irrigation/lavage of her abdomen and debridement of necrotic tissue. Wound cultures remained negative, and maximal antibiotic coverage did not halt tissue breakdown. A trial of steroids was initiated, and the patient’s condition subsequently improved. Tissue biopsy results were compatible with the diagnosis of PG.

From the *Department of Medical Education, St. George’s University, Great River, N.Y.; Department of General Surgery and Department of Pathology, Hackensack University Medical Center, Hackensack, N.J.; and §Department of General Surgery, University of Medicine and Dentistry of New Jersey, Newark, N.J.

Received for publication March 4, 2014; accepted April 11, 2014.

Disclosure: The authors have no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by the authors.

Ilan Berlinrut, MD, St. George’s University, 3500 Sunrise Highway, Building 300, Great River, NY 11739, E-mail: iberlinr@sgu.edu

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© 2014 American Society of Plastic Surgeons