Differential Diagnosis for Haemorrhagic Dermal Bullae in Wound Infections
- Single most likely diagnosis
- Streptococcus pyogenes: This bacterium is known for causing severe skin and soft tissue infections, including necrotizing fasciitis, which can present with haemorrhagic dermal bullae. Streptococcal infections are often associated with significant morbidity and mortality, making prompt identification crucial.
- Other Likely diagnoses
- Clostridium perfringens: While more commonly associated with gas gangrene, Clostridium perfringens can cause severe wound infections that might present with bullae, although these are less likely to be haemorrhagic compared to those caused by Streptococcus pyogenes.
- Coagulase-negative Staphylococcus: Though less commonly associated with severe skin infections compared to Staphylococcus aureus, coagulase-negative staphylococci can cause infections in compromised tissues or immunocompromised patients, potentially leading to abscesses or, less commonly, bullae.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Clostridium tetani: Tetanus infection can lead to severe muscle rigidity and spasms but is less commonly associated with dermal bullae. However, the infection can be fatal if not promptly treated, especially in non-immunized individuals, making it a critical diagnosis not to miss.
- Rare diagnoses
- Other rare bacterial or fungal infections could potentially cause haemorrhagic dermal bullae in the context of a wound infection, but these would be less common and might include infections such as those caused by Vibrio vulnificus (in seafood handlers or those exposed to contaminated water) or certain fungal pathogens in immunocompromised hosts.