When infection isn't infection

Ann R Coll Surg Engl. 2020 Oct;102(8):e183-e184. doi: 10.1308/rcsann.2020.0091. Epub 2020 Apr 29.

Abstract

Following open reduction and internal fixation for a proximal humerus fracture a 71-year-old man re-presented with wound changes consistent with infection and elevated inflammatory markers. No significant improvement was seen with concomitant intravenous antibiotics and multiple debridement procedures. This case was further complicated by soft tissue breakdown at the site of a left thigh haematoma also requiring debridement. Surgical site infections represent the most common cause of morbidity postoperatively. This case highlights the importance of considering a number of differential diagnoses. A diagnosis of pyoderma gangrenosum prompted systemic corticosteroid therapy giving rapid clinical improvement.

Keywords: Humeral fracture; ORIF; Open reduction and internal fixation; Pyoderma gangrenosum.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Debridement
  • Diagnosis, Differential
  • Fracture Fixation, Internal / adverse effects*
  • Humans
  • Humeral Fractures / surgery*
  • Male
  • Open Fracture Reduction / adverse effects*
  • Pyoderma Gangrenosum*
  • Thigh / pathology
  • Thigh / surgery