Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Apr 27, 2024; 16(4): 1176-1183
Published online Apr 27, 2024. doi: 10.4240/wjgs.v16.i4.1176
Suspected coexistence of perianal necrotizing sweet syndrome in chronic myelomonocytic leukemia: A case report
Ke-Qiang Yu, Hui-Xiang Li, Jing Wu
Ke-Qiang Yu, Clinical Medicine School, Chengdu University of Chinese Medicine, Chengdu 610072, Sichuan Province, China
Ke-Qiang Yu, Hui-Xiang Li, Jing Wu, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: All authors provided care for this patient; Yu KQ and Li HX drafted the manuscript and analyzed the data; and Wu J was responsible for conceptualization and supervision of the data mining.
Supported by the National Key Research and Development Program of China, No. 2021YFC2009100; Included in the information database of “Pelvic Diaphragm Health Archives”, No. 2021YFC2009103.
Informed consent statement: Written consent for publication was obtained from the patient.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read CARE Checklist (2016), and the manuscript was prepared and revised according to CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Jing Wu, MD, Doctor, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu 610041, Sichuan Province, China.
Received: October 12, 2023
Peer-review started: October 12, 2023
First decision: January 12, 2024
Revised: February 2, 2024
Accepted: March 11, 2024
Article in press: March 11, 2024
Published online: April 27, 2024

Chronic myelomonocytic leukemia (CMML) complicated with Sweet syndrome (SS) is a rare hematological neoplasm. However, cases of concomitant development of perianal necrotizing SS (NSS) have not been reported.


We report a case of a 49-year-old male patient who underwent sequential procedures for hemorrhoids and perianal abscess. He developed postoperative incision infection and was referred to the department where the authors work. Initially, perianal necrotizing fasciitis secondary to incision infection after perianal abscess surgery was suspected. Despite receiving antibiotic therapy and undergoing surgical debridement, deeper necrotic areas formed in the patient’s perianal wounds, accompanied by persistent high fever. Blood and fungal cultures yielded negative results. The final diagnosis was corrected to be CMML with suspected concomitant perianal NSS.


CMML with perianal NSS is a rare condition, often misdiagnosed as perianal abscess or perianal necrotizing fasciitis. Conventional antibiotic therapy and surgical debridement are ineffective in managing this condition.

Keywords: Chronic myelomonocytic leukemia, Sweet syndrome, Necrotizing fasciitis, Perianal abscess, Case report

Core Tip: Chronic myelomonocytic leukemia with Sweet syndrome (SS) is uncommon. Distinguishing between necrotizing SS (NSS) and necrotizing fasciitis can be challenging, despite significant differences in their treatment approaches. While prompt surgical debridement and antimicrobial therapy are crucial for patients with necrotizing fasciitis, antimicrobial therapy is ineffective in NSS, and surgical debridement may exacerbate the condition. Cases presenting with initial manifestations in the perianal region have not been reported previously. Therefore, our case study contributes to a better understanding of the etiology and symptomatic characteristics.