Pyoderma gangrenosum complicating a permanent pacemaker implantation: a case report and literature review
Open Access
- 12 March 2020
- journal article
- review article
- Published by Oxford University Press (OUP) in European Heart Journal - Case Reports
- Vol. 4 (2), 1-7
- https://doi.org/10.1093/ehjcr/ytaa049
Abstract
Pocket complications are common after cardiac implantable electronic device implantation. We report a rare case of pyoderma gangrenosum (PG) complicating a permanent pacemaker implantation, and the first literature review of 10 published cases. Five days after pacemaker implantation for heart failure and 2:1 atrioventricular block, a 93-year-old man had pain in the scar and bleeding on contact. Two days later, he had fever, inflammatory syndrome, and a necrotic 7-cm wound. The pacemaker was removed and he was started on antibiotics. Due to a lack of bacterial growth in samples, PG (a rare aseptic, destructive inflammatory cutaneous condition) was suspected, and histology was compatible with this diagnosis. High-dose corticosteroids vastly improved his condition within 1 week, and after 2 months of decreasing-dose corticosteroid therapy, complete healing and normalization of the inflammatory syndrome were observed. Pyoderma gangrenosum should be considered if there is aseptic skin ulceration that is not controlled by antibiotic treatment. The first-line treatment for PG is high-dose systemic corticosteroids.Keywords
This publication has 12 references indexed in Scilit:
- Incidence and predictors of short- and long-term complications in pacemaker therapy: The FOLLOWPACE studyHeart Rhythm, 2012
- Pyoderma gangraenosum nach AICD-ImplantationDer Anaesthesist, 2012
- Pyoderma gangrenosum complicating an implantable cardioverter defibrillator wound in a patient with ulcerative colitisEP Europace, 2009
- Pyoderma gangrenosum: an updated reviewJournal of the European Academy of Dermatology and Venereology, 2009
- Pyoderma gangrenosum following pacemaker insertionClinical and Experimental Dermatology, 2009
- Pyoderma gangrenosum complicating pacemaker implantEP Europace, 2006
- Recurrent postoperative pyoderma gangrenosum complicating pacemaker insertionJournal of the European Academy of Dermatology and Venereology, 2006
- [Pyoderma gangrenosum after a pacemaker implantation--case report].2005
- Pyoderma gangrenosum presented as a refractory wound infection following permanent pacemaker implantationHeart, 2002
- Pyoderma gangrenosum after pace maker implantationJournal of the European Academy of Dermatology and Venereology, 1998