Yu KQ, Li HX, Wu J. Suspected coexistence of perianal necrotizing sweet syndrome in chronic myelomonocytic leukemia: A case report. World J Gastrointest Surg 2024; 16(4): 1176-1183 [PMID: 38690058 DOI: 10.4240/wjgs.v16.i4.1176]
Corresponding Author of This Article
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. wujing@wchscu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
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 bythe 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: https://creativecommons.org/Licenses/by-nc/4.0/
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. wujing@wchscu.cn
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
Abstract
BACKGROUND
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.
CASE SUMMARY
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.
CONCLUSION
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.
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.
