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Pyoderma gangrenosum following cesarean delivery
U A Steadman1, T E Brennan, L A Daman
1Department of Obstetrics and Gynecology, Hartford Hospital, Connecticut 06102-5037, USA.
Background:
Pyoderma gangrenosum is a rare, chronic inflammatory disease that can develop after minor trauma or surgery. Most reports of this condition developing after abdominal surgery have been reported following ostomy formation. A number of systemic diseases have been associated with this disorder, most commonly inflammatory bowel disease, though 40-50% of cases have no associated systemic disease.
Case:
A 32-year-old woman developed spiking fever and purulent appearing wound discharge with a rolled erythematous border after cesarean delivery. Her condition worsened despite various regimens of intravenous antibiotics and local treatment. Pyoderma gangrenosum was diagnosed. Treatment with steroids resolved the lesion, and associated systemic diseases were not found.
Conclusion:
Consideration of the diagnosis of pyoderma gangrenosum in cases of apparent wound infections unresponsive to antibiotics should result in early diagnosis and treatment of this condition.