Pyoderma gangrenosum mimicking mediastinitis after cardiac surgery: a case study.
Pyoderma gangrenosum is a dermatosis which associates both, necrosis and polynuclear infiltration of the skin. While the aetiology is not well understood, the disease is thought to be due to immune system dysfunction and it can occur after minor trauma or surgery. Although it has seldom been reported after cardiac surgery in the literature, it is not exceptional. Here we report a case of pyoderma gangrenosum after coronary artery bypass grafting in a 76-year-old patient with chronic idiopathic myelofibrosis. Diagnosis was clinically made and the patient was treated with systemic steroids. The lesions showed a remarkable improvement with this therapy. In the field of cardiac surgery, physicians of the surgical team and nurses should think about this diagnosis in all rapidly expanding postoperative lesions without improvement after debridement or antibiotics.


BACKGROUND
The authors have no conflicts of interest to declare.
Surgeon, Department of Cardiac Surgery, University Teaching Hospital of Lille, Lille, France.
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Hysi
Surgeon, Department of Cardiac Surgery, University Teaching Hospital of Lille, Lille, France.
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Vincentelli
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000789:Angina, Unstable / Q000150:complications / Q000601:surgery*; D001026:Coronary Artery Bypass; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000175:diagnosis*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000188:drug therapy; D055728:Primary Myelofibrosis / Q000150:complications; D017511:Pyoderma Gangrenosum / Q000175:diagnosis* / Q000188:drug therapy
D000305:Adrenal Cortex Hormones
cardiac surgery; pyoderma gangrenosum; surgical wound