title: Untreatable surgical site infection: consider pyoderma gangrenosum.
abstract: Pyoderma gangrenosum (PG) is an inflammatory disease characterized by sterile infiltration of the skin by neutrophils. We describe a case of a 63-year-old woman who developed PG following an abdominal wall reconstruction. Her initial presentation was thought to be consistent with a surgical site infection. Antibiotic therapy was initiated, and the patient was taken for multiple irrigation/lavage of her abdomen and debridement of necrotic tissue. Wound cultures remained negative, and maximal antibiotic coverage did not halt tissue breakdown. A trial of steroids was initiated, and the patient's condition subsequently improved. Tissue biopsy results were compatible with the diagnosis of PG.
authors.affiliation: Department of Medical Education, St. George's University, Great River, N.Y.; Department of General Surgery and Department of Pathology, Hackensack University Medical Center, Hackensack, N.J.; and Department of General Surgery, University of Medicine and Dentistry of New Jersey, Newark, N.J.
authors.forename: Ilan
authors.initials: I
authors.lastname: Berlinrut
authors.affiliation: Department of Medical Education, St. George's University, Great River, N.Y.; Department of General Surgery and Department of Pathology, Hackensack University Medical Center, Hackensack, N.J.; and Department of General Surgery, University of Medicine and Dentistry of New Jersey, Newark, N.J.
authors.forename: Nitasha
authors.initials: N
authors.lastname: Bhatia
authors.affiliation: Department of Medical Education, St. George's University, Great River, N.Y.; Department of General Surgery and Department of Pathology, Hackensack University Medical Center, Hackensack, N.J.; and Department of General Surgery, University of Medicine and Dentistry of New Jersey, Newark, N.J.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Josse
authors.affiliation: Department of Medical Education, St. George's University, Great River, N.Y.; Department of General Surgery and Department of Pathology, Hackensack University Medical Center, Hackensack, N.J.; and Department of General Surgery, University of Medicine and Dentistry of New Jersey, Newark, N.J.
authors.forename: David
authors.initials: D
authors.lastname: de Vinck
authors.affiliation: Department of Medical Education, St. George's University, Great River, N.Y.; Department of General Surgery and Department of Pathology, Hackensack University Medical Center, Hackensack, N.J.; and Department of General Surgery, University of Medicine and Dentistry of New Jersey, Newark, N.J.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Kaul