Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2016; 83(2):127-130 | DOI: 10.55095/achot2016/020

Pyoderma Gangrenosum Mimicking Necrotising Fasciitis after Rotator Cuff ReconstructionCase report

J. VČELÁK^1,*, R. ŠUMAN¹, J. BENEŠ²

¹ Ortopedická klinika 1. lékařské fakulty Univerzity Karlovy v Praze, Nemocnice Na Bulovce, Praha

² Klinika infekčních, parazitárních a tropických nemocí 3. lékařské fakulty Univerzity Karlovy v Praze, Nemocnice Na Bulovce, Praha

Gangrenous pyoderma is a rare complication of surgical treatment mimicking bacterial necrotizing fasciitis. The characteristic symptoms include a pre-existing immune disorder, negative results of the relevant microbiological examinations, no response to any antibiotic therapy, and deteriorating of the condition after radical debridement. Another typical feature is a discrepancy between an ominous appearance of the wound accompanied by leucocytosis and an elevated CRP level, and the patient s good general condition with low-grade fever and no signs of sepsis.
The case of a 68-year-old man who underwent an elective open reconstruction of rotator cuff tears of the left shoulder is presented. The surgery was complicated with pyoderma gangrenosum that was first treated unsuccessfully by repeated revision surgery and broad-spectrum antibiotic therapy. The patient was ultimately cured with corticosteroids. The sequellae included limited motion of the shoulder joint and extensive destruction and scarring of the adjacent soft tissue.

Keywords: gangrenous pyoderma, necrotizing fasciitis, corticosteroids

Published: April 1, 2016  Show citation