Nina Berger1, Michael Ebenhoch, Maya Salzmann. 1. *Department of Children's Orthopedics, Hospital for Children Munich-Schwabing, Munich †BG Trauma Center Murnau, Murnau, Germany.
Abstract
BACKGROUND: Postoperative pyoderma gangrenosum (PG) is a neutrophilic dermatosis and pathergic reaction at surgical sites. Reports of children with postoperative PG are rare in the literature. METHODS: We report the case of a 13-year-old boy without any known preexisting illnesses, who developed severe systemic response and wound deterioration after elective hip reconstruction surgery. The working diagnosis of necrotizing fasciitis was later determined to be postoperative PG. RESULTS: The patient was successfully treated by the systemic application of corticosteroids. CONCLUSIONS: Postoperative PG is a very rare complication after surgery, especially in children. If mistaken for necrotizing fasciitis, it can substantially mutilate a patient because PG is worsened by surgical debridement. It can be treated successfully only by corticosteroids and other immunosuppressive drugs. LEVEL OF EVIDENCE: Level IV-this is a case report.
BACKGROUND:Postoperative pyoderma gangrenosum (PG) is a neutrophilic dermatosis and pathergic reaction at surgical sites. Reports of children with postoperative PG are rare in the literature. METHODS: We report the case of a 13-year-old boy without any known preexisting illnesses, who developed severe systemic response and wound deterioration after elective hip reconstruction surgery. The working diagnosis of necrotizing fasciitis was later determined to be postoperative PG. RESULTS: The patient was successfully treated by the systemic application of corticosteroids. CONCLUSIONS: Postoperative PG is a very rare complication after surgery, especially in children. If mistaken for necrotizing fasciitis, it can substantially mutilate a patient because PG is worsened by surgical debridement. It can be treated successfully only by corticosteroids and other immunosuppressive drugs. LEVEL OF EVIDENCE: Level IV-this is a case report.
Authors: Michał Wasiak; Michał Ciszek; Ireneusz Babiak; Piotr Wasilewski; Paweł Łęgosz; Bartosz Kieroński; Paweł Małdyk Journal: Reumatologia Date: 2022-09-08