Necrotic donor-site ulcer due to Klebsiella pneumonia e infection following pubic hair follicular unit transfer in an undiagnosed diabetic: A rare case report

Hair transplantation is a safe esthetic procedure, and donor-site complications are uncommon. We report a rare case of necrotic ulceration at a pubic hair donor site caused by Klebsiella pneumoniae in a previously undiagnosed diabetic patient. A 52-year-old man presented 6 weeks after undergoing follicular unit transfer involving scalp and pubic grafts, with painful swelling and ulceration in the inguinal region. Examination revealed a tender erythematous swelling and a 3 × 5 cm necrotic ulcer with adherent black eschar and surrounding erythema. Laboratory investigations were normal except for elevated random blood glucose (283 mg/dL). Wound culture grew K. pneumoniae , sensitive to doxycycline. The patient was treated with sharp surgical debridement, enzymatic wound care, oral doxycycline, topical mupirocin, and initiation of antidiabetic therapy. Complete healing occurred within 3 weeks without compromise of graft survival. This case underscores the importance of metabolic screening and early culture-guided management in preventing donor-site morbidity.