Surgical site infection secondary to caesarean section: Case report of unrecognized pyoderma gangrenosum

AbstractPyoderma gangrenosum(PG) is an uncommon form of ulcerative neutrophilic dermatosisan(ND) presented as painful ulcerated skin at sites of injury or surgery. A 19-year-old primigravida was found signs of ulcerative wound skin defects liking surgical site infection after caesarean section. Despite antibiotic treatment and consecutive debridement procedures were all performed, progressive deterioration of the wound occurred. PG was diagnosed by clinically progressive skin necrosis and negative wound cultures. After several weeks, the abdominal wall defect was surgically corrected with systemic corticosteroid therapy and skin grafting. A sense mutation identified by whole-exome sequencing (WES) was located within NFKB1, chr4:103498062–103498096, which may be related to PG. Postoperative PG can mimic infectious diseases, but the treatment is substantially different. This case of PG highlights the importance of timely recognition and treatment of the disease.