The Wound That Hated Debridement: Recognizing Pathergy and Great mimics of Diabetic Foot Infection

A patient with a presumed infected diabetic foot ulcer worsens after debridement and escalating antibiotics. This episode explores pathergy — an exaggerated inflammatory response to minor trauma that can mimic infection — and how misdiagnosis leads to harmful over-treatment. Learn how to recognize red flags (rapid enlargement after intervention, pain out of proportion, violaceous borders, negative cultures) and why management often requires restraint, anti-inflammatory therapy, and targeted immunomodulation rather than repeated surgical debridement.