A case of pyoderma gangrenosum after mitral valve replacement
Takahashi, R.; Kiso, I.; Mori, A.; Inoue, Y.; Inoue, Y.
Kyobu Geka. Japanese Journal of Thoracic Surgery 54(13): 1128-1130
2001
ISSN/ISBN: 0021-5252 PMID: 11761900 Document Number: 538318
A 48-year-old male with treated hypothyroidism underwent mechanical valve replacement for mitral valve regurgitation. After the operation, the patient developed progressive median chest wound ulceration. The wound did not heal with conventional therapies for mediastinitis such as administration of antibiotics, debridement of necrotic tissue or continuous irrigation. The entire surgical wound opened spontaneously. Bacterial cultures yielded negative and the wound biopsy specimen revealed non-specific inflammatory change. The anti-TSH receptor antigen level was high. Pyoderma gangrenosum based on auto-immune deficiency was diagnosed and high dose corticosteroid therapy was started. The wound healed completely in 5 months.