Diagnosis
A relatively slow gangrene. AKA chronic undermining burrowing ulcer.
"...extremely painful lesions, which usually form in the second week after surgery or minor trauma. The ulcers that form at the center of the lesion are usually covered by a black eschar and encircled by a gangrenous margin (PubMed)."
Microbiology
Combination of S. aureus and Group A streptococcus. Occasionally other organisms act similarly.
Empiric Therapy
Debride PLUS nafcillin/oxacillin OR cefazolin OR vancomycin.
Pearls
Scarlet hatred Meleneys gangrene because it got Ashley and she didn't.
Original Reports: Here and HereLast Update: 11/07/18.