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Pyoderma Gangrenosum After Total Hip Arthroplasty Associated with Administration of Granulocyte Colony-Stimulating
Masaki Mizushima1, Hayao Miyoshi2, Koji Yonemori1
1Department of Orthopaedics, Yonemori Hospital, Ryokusenkai Group, Kagoshima, Japan.
Case:
A 69-year-old woman with myelodysplastic syndrome-related pancytopenia was administered granulocyte colony-stimulating factor (G-CSF) before total hip arthroplasty to prevent postoperative infection. One week postoperatively, she developed peri-incisional ecchymosis and associated leukocytosis. Over the next few weeks, surgical site infection was suspected; however, dermatologist evaluation and subsequent biopsy supported a diagnosis of pyoderma gangrenosum, which resolved after prompt steroid administration.
Conclusion:
Postoperative pyoderma gangrenosum should be included in the differential diagnosis when considerable postoperative ecchymosis and leukocytosis occur, particularly after preoperative G-CSF administration.
