Ruptured ulcerated and inflammed gout tophi with deep soft tissue infection of left foot – when rheumatology meets surgery: a case report treated with local ozone therapy

Abstract

Tophaceouse gout is a rare condition and chronic complication of gout due to storage of derivates of uric acid – crystals of monosodium urate, accompanied by lipids, mucopolisaharides matrix and proteins. Rheumatology meets the surgery in cases of rupture, ulceration and inflammation of tophi with complication with severe soft tissue infection, sepsis, large swelling, destruction of affected joints and periphery neuropathy chronic pain. Spontaneous or traumatic perforation and ulceration of tophi are rare conditions, that’s why there no any rheumatology or surgical guideline for management of that condition. We present a case report of male patient with posttraumatic perforated gout tophus and soft tissue secondary infection of left foot. He was treated with standard  surgical debridement and local ozone therapy with stabilized ozonides over wound surface. That article presents a pioneer experience in the treatment of complicated tophaceouse gout with topical administration of ozonated olive oil with vitamin E and shows the effect of that treatment in progress.