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Related Concept Videos

Acute Pyelonephritis I: Introduction01:27

Acute Pyelonephritis I: Introduction

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Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
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Endocarditis II: Clinical Features of Infective Endocarditis01:25

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Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
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Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Skin Diseases and Disorders01:23

Skin Diseases and Disorders

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Skin is the first line of defense and encounters a variety of microbes. Some pathogenic strains are often the cause of a broad range of infections of the skin and other body systems. These conditions can affect people of all ages and may have different causes, including genetic factors, infections, autoimmune reactions, environmental factors, and lifestyle choices.
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A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis
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Pyoderma Gangrenosum Mimicking Necrotizing Fasciitis: A Case Report.

Takahiro Hase1, Akihiro Orita1, Takuya Mizukami1

  • 1Dermatology, Kushiro City General Hospital, Kushiro, JPN.

Cureus
|July 24, 2025
PubMed
Summary
This summary is machine-generated.

Pyoderma gangrenosum (PG) can mimic necrotizing fasciitis (NF), complicating diagnosis. Early clinical signs like pustules and absence of fat necrosis aid in differentiating PG, preventing unnecessary surgery.

Keywords:
adalimumab (humira)autoinflammatory diseasenecrotizing fascitisneutrophilic dermatosispyoderma gangenosum

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Area of Science:

  • Dermatology
  • Immunology

Background:

  • Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis with variable clinical presentations.
  • PG can be misdiagnosed as infectious or other inflammatory conditions, delaying appropriate treatment.

Observation:

  • A 68-year-old woman presented with knee swelling, erythema, papules, and pustules post-fall, initially suspected as necrotizing fasciitis (NF).
  • Despite antibiotics and debridement, her condition worsened, with persistent fever and elevated inflammatory markers.
  • Histopathology revealed neutrophilic infiltrate, and cultures were negative, supporting a PG diagnosis.

Findings:

  • Pustular PG was diagnosed based on abundant pustules and lack of fat necrosis during surgery.
  • Oral prednisolone rapidly resolved symptoms, followed by wound therapy, skin grafting, and adalimumab.
  • The patient achieved clinical stability without relapse.

Implications:

  • Distinguishing PG from NF is crucial due to overlapping presentations and potential for aggressive management.
  • Clinical assessment, including evaluation of skin lesions and fat necrosis, is vital for early PG diagnosis.
  • Considering PG in atypical presentations of suspected NF can prevent unnecessary surgical interventions and guide timely treatment.