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Medline ® Abstract for Reference 65

of 'Necrotizing soft tissue infections'

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.
Berger N, Ebenhoch M, Salzmann M
J Pediatr Orthop. 2017;37(6):e379.
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.
*Department of Children's Orthopedics, Hospital for Children Munich-Schwabing, Munich†BG Trauma Center Murnau, Murnau, Germany.