Postoperative Pyoderma Gangrenosum in Children: The Case Report of a 13-Year-Old Boy With Pyoderma Gangrenosum After Hip Reconstruction Surgery and a Review of the Literature

被引:6
作者
Berger, Nina [1 ]
Ebenhoch, Michael [2 ]
Salzmann, Maya [1 ]
机构
[1] Hosp Children Munich Schwabing, Dept Childrens Orthoped, Kolner Pl 1, D-80804 Munich, Germany
[2] BG Trauma Ctr Murnau, Murnau, Germany
关键词
necrotizing fasciitis; pyoderma gangrenosum; postoperative wound infection; sterile pus; NEUTROPHILS; MANAGEMENT; RISK;
D O I
10.1097/BPO.0000000000000952
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
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.
引用
收藏
页码:E379 / E383
页数:5
相关论文
共 30 条
[1]   Perivascular macrophages mediate neutrophil recruitment during bacterial skin infection [J].
Abtin, Arby ;
Jain, Rohit ;
Mitchell, Andrew J. ;
Roediger, Ben ;
Brzoska, Anthony J. ;
Tikoo, Shweta ;
Cheng, Qiang ;
Ng, Lai Guan ;
Cavanagh, Lois L. ;
von Andrian, Ulrich H. ;
Hickey, Michael J. ;
Firth, Neville ;
Weninger, Wolfgang .
NATURE IMMUNOLOGY, 2014, 15 (01) :45-53
[2]   Aberrant neutrophil trafficking and metabolic oscillations in severe pyoderma gangrenosum [J].
Adachi, Y ;
Kindzelskii, AL ;
Cookingham, G ;
Shaya, S ;
Moore, EC ;
Todd, RF ;
Petty, HR .
JOURNAL OF INVESTIGATIVE DERMATOLOGY, 1998, 111 (02) :259-268
[3]   Pediatric Pyoderma Gangrenosum with Splenic and Pulmonary Involvement [J].
Allen, Caroline P. ;
Hull, Jeremy ;
Wilkison, Nick ;
Burge, Susan M. .
PEDIATRIC DERMATOLOGY, 2013, 30 (04) :497-499
[4]   Pyoderma gangrenosum - A diagnosis not to be missed [J].
Armstrong, PM ;
Ilyas, I ;
Pandey, R ;
Berendt, AR ;
Conlon, CP ;
Simpson, AHRW .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1999, 81B (05) :893-894
[5]   A comparison of typical and atypical forms with an emphasis on time to remission. Case review of 86 patients from 2 institutions [J].
Bennett, ML ;
Jackson, JM ;
Jorizzo, JL ;
Fleischer, AB ;
White, WL ;
Callen, JP .
MEDICINE, 2000, 79 (01) :37-46
[6]   Neutrophilic Dermatoses in Children [J].
Berk, David. R. ;
Bayliss, Susan J. .
PEDIATRIC DERMATOLOGY, 2008, 25 (05) :509-519
[7]  
BREITBART E, 1979, HAUTARZT, V30, P314
[8]   Pyoderma (echthyma) gangrenosum - Clinical and experimental observations in five cases occurring in adults [J].
Brunsting, LA ;
Goeckerman, WH ;
O'Leary, PA .
ARCHIVES OF DERMATOLOGY AND SYPHILOLOGY, 1930, 22 (04) :655-680
[9]   Superficial granulomatous pyoderma: report of a case of an uncommon variant of pyoderma gangrenosum [J].
Camargo Villela Berbert, Alceu Luiz ;
de Oliveira Mantese, Sonia Antunes ;
Rocha, Ademir ;
Rezende, Juliana ;
Rodrigues Cunha, Thania Ferreira .
ANAIS BRASILEIROS DE DERMATOLOGIA, 2009, 84 (03) :285-288
[10]   Refractory pyoderma gangrenosum treated with infliximab in an infant [J].
Campos-Munoz, L. ;
Conde-Taboada, A. ;
Aleo, E. ;
Toledano, E. ;
Lopez-Bran, E. .
CLINICAL AND EXPERIMENTAL DERMATOLOGY, 2014, 39 (03) :336-339