Pyoderma gangrenosum after minor trauma in a pregnant woman, mistaken for necrotizing fasciitis: report of a case and literature review

Surg Infect (Larchmt). 2014 Aug;15(4):441-4. doi: 10.1089/sur.2012.110. Epub 2014 Jan 29.


Background: Pyoderma gangrenosum is an ulcerative, non-infectious skin disorder. However, it can be mistaken as necrotizing fasciitis, a life-threatening infective condition. We describe here a case of pyoderma gangrenosum after minor trauma treated as necrotizing fasciitis.

Methods: Case report and literature review.

Case report: A 27-year-old pregnant nurse had a pretibial wound after a fall on a rough surface. When erythema developed and no response to empirical antibiotic therapy was observed, multiple debridements were performed. Paradoxically, her condition became worse. The diagnosis of pyoderma gangrenosum was suspected. Treatment with corticosteroids was started and this was successful.

Conclusion: Pyoderma gangrenosum can mimic infectious necrotizing fasciitis. Differentiating these two conditions is important because mistreatment of pyoderma can lead to disfigurement.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Inflammatory Agents / therapeutic use
  • Debridement
  • Diagnosis, Differential
  • Fasciitis, Necrotizing / diagnosis*
  • Fasciitis, Necrotizing / pathology*
  • Female
  • Humans
  • Lower Extremity / pathology
  • Pregnancy
  • Pregnancy Complications, Infectious*
  • Pyoderma Gangrenosum / diagnosis*
  • Pyoderma Gangrenosum / drug therapy
  • Pyoderma Gangrenosum / pathology*
  • Pyoderma Gangrenosum / surgery
  • Treatment Outcome
  • Wounds and Injuries / complications*


  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents