Differential Diagnosis for Green Discharge from Wound
Single Most Likely Diagnosis
- Pseudomonas aeruginosa infection: This is a common cause of green discharge due to the production of pyocyanin, a green pigment. Pseudomonas infections are often associated with wounds, especially in immunocompromised patients or those with exposure to contaminated water.
Other Likely Diagnoses
- Staphylococcal infection: While not typically green, staph infections can produce a thick, purulent discharge that may appear greenish due to the presence of other bacteria or debris.
- Proteus mirabilis infection: This bacterium can produce a greenish discharge due to its ability to break down urea, although this is less common than Pseudomonas.
- Wound contamination with environmental organisms: Exposure to contaminated soil, water, or other environmental sources can introduce bacteria that produce pigments, leading to colored discharge.
Do Not Miss Diagnoses
- Necrotizing fasciitis: Although the discharge may not always be green, this condition is a medical emergency that requires prompt recognition and treatment. The presence of any foul-smelling discharge, especially with signs of tissue necrosis, should raise suspicion.
- Gas gangrene: Caused by Clostridium species, this condition can produce a foul-smelling, possibly discolored discharge due to gas production in tissues. It is a life-threatening condition that requires immediate intervention.
Rare Diagnoses
- Chromobacterium violaceum infection: This bacterium produces a violet pigment but can occasionally cause infections with greenish discharge, especially in tropical regions.
- Burkholderia cepacia complex infection: While more commonly associated with respiratory infections in cystic fibrosis patients, these bacteria can produce pigments and cause wound infections with colored discharge in rare cases.