Steadman U A, Brennan T E, Daman L A, Curry S L
Department of Obstetrics and Gynecology, Hartford Hospital, Connecticut 06102-5037, USA.
Obstet Gynecol. 1998 May;91(5 Pt 2):834-6.
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.
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.
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.
坏疽性脓皮病是一种罕见的慢性炎症性疾病,可在轻微创伤或手术后发生。腹部手术后发生这种疾病的大多数报告是在造口形成后。许多全身性疾病与这种疾病有关,最常见的是炎症性肠病,尽管40%-50%的病例没有相关的全身性疾病。
一名32岁女性剖宫产术后出现高热和伤口脓性分泌物,伤口边缘呈红斑状卷曲。尽管采用了各种静脉抗生素治疗方案和局部治疗,她的病情仍恶化。诊断为坏疽性脓皮病。使用类固醇治疗使病变消退,未发现相关的全身性疾病。
对于对抗生素无反应的明显伤口感染病例,考虑坏疽性脓皮病的诊断应能实现对该疾病的早期诊断和治疗。