Postoperative Pyoderma Gangrenosum: Rare Infection Mimic and Diagnostic Challenge – A Case Report.

Background: Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis that can occur in the postoperative period, often mimicking surgical site infections (SSIs). The clinical overlap between PG and SSIs – including erythema, wound dehiscence, and purulent discharge – makes timely diagnosis challe...

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Published in:Visceral Medicine Vol. 42; no. 2; pp. 92 - 96
Main Authors: Aldarwish, Saeed, Schafmayer, Clemens, Hinz, Sebastian
Format: case study pictorial tables/charts Journal Article
Published: Karger AG 2026
Online Access:View this record in EBSCOhost
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      dt: 2026
      vid: 42
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      pub: Karger AG
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        10.1159/000550349
        193060299
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        atl: Postoperative Pyoderma Gangrenosum: Rare Infection Mimic and Diagnostic Challenge – A Case Report.
      aug:
        au:
          Aldarwish, Saeed
          Schafmayer, Clemens
          Hinz, Sebastian
        affil: Department of Surgery, University Medical Center Rostock, Rostock, Germany
      sug:
        subj:
          Pyoderma Gangrenosum Diagnosis
          Postoperative Complications
          Diagnosis, Differential
          Pyoderma Gangrenosum Drug Therapy
          Surgical Wound Infection
          Wound Healing
          Biopsy
          Pyoderma Gangrenosum Physiopathology
          Microbial Culture and Sensitivity Tests
          Tomography, X-Ray Computed
          Adrenal Cortex Hormones Therapeutic Use
          Immunosuppression
          Wound Care
          Transferases Therapeutic Use
          Autoimmune Diseases
          Surgical Wound Dehiscence
          Necrosis
          Inflammation
          Dermatology
          Hematologic Tests
          NF-kappa B Blood
          cGAS-STING Signaling Pathway
          Phenotype
          Tumor Necrosis Factor Blood
          Interleukins Blood
      ab: Background: Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis that can occur in the postoperative period, often mimicking surgical site infections (SSIs). The clinical overlap between PG and SSIs – including erythema, wound dehiscence, and purulent discharge – makes timely diagnosis challenging. Case Presentation: A 61-year-old female with a history of ovarian cancer and metachronous liver metastasis underwent an open left hemihepatectomy. On the fifth postoperative day, she developed erythema, wound dehiscence, and necrosis unresponsive to broad-spectrum antibiotics. Wound cultures remained sterile. Dermatologic consultation and histopathology confirmed the diagnosis of PG, characterized by dense neutrophilic infiltration and pyogenic folliculitis. High-dose corticosteroid therapy led to marked clinical improvement within 5 days, with full wound healing achieved by discharge. Conclusion: Postoperative PG should be considered in non-resolving postoperative wound complications with negative cultures and antibiotic failure. In this context, prior exposure to PARP inhibitors may be a biologically plausible cofactor through immune modulation; however, a causal link remains unproven. Early dermatology consultation and biopsy are essential to avoid harmful debridement and expedite immunosuppression.
      pubtype: Academic Journal
      doctype:
        case study
        pictorial
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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