Differential Diagnosis for Green Snotty Drainage from Wound

• Single Most Likely Diagnosis
  • Pseudomonas aeruginosa infection: This is a common cause of greenish discharge due to the production of pyocyanin, a pigment that gives the discharge its characteristic color. 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.
  • Anaerobic bacterial infection: Anaerobes can produce a foul-smelling, greenish discharge due to the breakdown of tissue and the production of volatile fatty acids.
  • Fungal infection: Certain fungi, such as Aspergillus, can produce a greenish discharge, although this is less common than bacterial infections.
• Do Not Miss Diagnoses
  • Necrotizing fasciitis: Although the discharge may not always be green, this is a life-threatening condition that requires prompt diagnosis and treatment. The presence of any signs of necrotizing fasciitis, such as severe pain, swelling, or crepitus, warrants immediate attention.
  • Gas gangrene: Similar to necrotizing fasciitis, gas gangrene is a serious condition that can produce a foul-smelling discharge and requires prompt treatment.
• Rare Diagnoses
  • Actinomycosis: A rare bacterial infection that can produce a greenish discharge, often accompanied by the presence of "sulfur granules" in the wound.
  • Chromobacteriosis: A rare infection caused by Chromobacterium violaceum, which can produce a greenish pigment called violacein.
  • Mycobacterial infection: Certain mycobacteria, such as Mycobacterium abscessus, can produce a greenish discharge, although this is relatively rare.