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J Eur Acad Dermatol Venereol 2019 Mar 21. Epub 2019 Mar 21.

Department of Dermatology, Hôpital Saint André, University Hospital Bordeaux, Bordeaux, France.

Distinguishing between pyoderma gangrenosum (PG) and necrotising fasciitis (NF) can be challenging in certain cases because the treatments are very different (1). We report a case that led us to consider the differential diagnosis of both conditions, and also their association. A 43-year-old woman developed, in the early hours following excision of an inguinal epidermal cyst, a necrotic inflammatory ulceration with fever, general weakness and signs of septic shock. Read More

Microorganisms 2019 Mar 18;7(3). Epub 2019 Mar 18.

Department of Biotechnology, Cochin University of Science and Technology, Kochi-682022, Kerala, India.

and the causative agents of Vibriosis in marine vertebrates and invertebrates, are also responsible for fatal illnesses such as gastroenteritis, septicemia, and necrotizing fasciitis in humans via the ingestion of contaminated seafood. Aquaculture farmers often rely on extensive prophylactic use of antibiotics in farmed fish to mitigate and their biofilms. This has been postulated as being of serious concern in the escalation of antibiotic resistant . Read More

Rev Med Inst Mex Seguro Soc 2019 Mar 15;56(6):566-569. Epub 2019 Mar 15.

Instituto Mexicano del Seguro Social, Hospital General Regional de Zona 1, Unidad “Morelos”, Servicio de Medicina Interna. Chihuahua, Chihuahua, México

Background: The physiological properties of the interstitial subcutaneous tissue of the limbs could bring the abnormal distribution of air coming from superficial trauma of the skin. We present the case of a young woman who developed subcutaneous emphysema after a superficial trauma and discussed the differential diagnosis and treatment.

Clinical Case: A teenager woman 13 years old had subcutaneous emphysema in the left arm, following the scratch produced by her cat, of two months of evolution, without signs suggestive of local or systemic infection, it was resolved spontaneously during the period of observation. Read More

Eur Radiol 2019 Mar 18. Epub 2019 Mar 18.

Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.

Objectives: To develop and validate a scoring system integrating MRI and laboratory findings to differentiate necrotizing fasciitis (NF) from non-necrotizing fasciitis (non-NF).

Methods: This retrospective study included 144 subjects who underwent surgery in one of three tertiary referral centers for NF or cellulitis with non-NF. The development cohort consisted of 96 subjects (NF = 47; non-NF = 49) from one center, and the validation cohort consisted of 48 subjects (NF = 23; cellulitis with non-NF = 25) from two different centers. Read More

BMJ Case Rep 2019 Mar 14;12(3). Epub 2019 Mar 14.

Internal Medicine, Presence Saint Joseph Hospital Chicago, Chicago, Illinois, USA.

Necrotising fasciitis (NF) resulting from sigmoid perforation is rare, but none the less remains life threatening. Early surgical intervention and empiric broad-spectrum antibiotic remains the standard of care. A 65-year-old man with history of stage 4 rectal cancer presented with bilateral hip pain. Read More

J Craniofac Surg 2019 Mar 6. Epub 2019 Mar 6.

Department of Oral and Maxillofacial Surgery.

Internal jugular vein thrombosis (IJVT) is a rare complication of cervical necrotizing fasciitis (CNF) which may lead to life threat. This article reports a patient with severe CNF complicated with IJVT, and combined with the literature to analyze the diagnosis and treatment of CNF and IJVT. Read More

HSS J 2019 Feb 8;15(1):84-92. Epub 2019 Jan 8.

2UHealth Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, FL USA.

Background: Given the high prevalence of musculoskeletal conditions in the USA, it is important for orthopedic surgeons to promptly identify patients who may be at risk for opioid misuse.

Questions/purposes: The aim of this literature review was to elucidate various musculoskeletal pathologies and complications, as seen on imaging, that may indicate opioid misuse or opioid use disorder.

Methods: A literature search was conducted using the PubMed, Scopus, and Cochrane Library databases for articles related to imaging findings associated with chronic opioid use or misuse in orthopedic patients. Read More

Ann R Coll Surg Engl 2019 Mar 11:1-10. Epub 2019 Mar 11.

Department of Trauma and Orthopaedics, Aberdeen Royal Infirmary , Aberdeen , UK.

Introduction: Necrotising fasciitis is a life-threatening rapidly progressing bacterial infection of the skin requiring prompt diagnosis and treatment. Optimum care warrants a combination of surgical debridement, antibiotics and intensive care support. All cases of necrotising fasciitis in 10 years in the North East of Scotland were reviewed to investigate and improve patient care. Read More

SAGE Open Med Case Rep 2019 1;7:2050313X19834425. Epub 2019 Mar 1.

Section of Infectious Diseases, Department of Medicine, School of Medicine, Boston University, Boston, MA, USA.

Fournier's gangrene is classically associated with diabetes mellitus and alcohol use disorder. While it is associated with chemotherapy, there are few case reports of Fournier's gangrene as the initial presentation of acute myelogenous leukemia. A 38-year-old male presented with progressive scrotal swelling and hematochezia. Read More

J Craniofac Surg 2019 Feb 9. Epub 2019 Feb 9.

Department of Ophthalmology.

Periorbital necrotizing fasciitis (NF) is a very rare disease with a mortality rate of 10% to 20%, requiring rapid diagnosis and active treatment. The most common causative organism is Group A β-hemolytic Streptococcus, and trauma, operative incisions, pre-existing ulcers, or injection sites may be predisposing factors for periorbital NF. In this study, the subject, who had a medical history of diabetes mellitus and chronic liver disease, developed periorbital NF suddenly and without any specific triggering factors, and Klebsiella pneumoniae was identified in a necrotic tissue biopsy. Read More

J Orthop Surg Res 2019 Mar 6;14(1):73. Epub 2019 Mar 6.

Department of Emergency Medicine, Chang Gung Memorial Hospital, No.6, Sec. W., Jiapu Rd., Puzi City, Chiayi County, 613, Taiwan, Republic of China.

Background: Hyperlactatemia is known to be associated with adverse outcome in critical illness. In this study, we attempted to identify if hyperlactatemia on emergency department (ED) arrival is a reliable predictor for in-hospital mortality in necrotizing fasciitis (NF) patients.

Method: A prospective cohort study of hospitalized patients with NF was conducted in two tertiary teaching hospitals in Taiwan between March 2010 and March 2018. Read More

GMS Interdiscip Plast Reconstr Surg DGPW 2019 4;8:Doc02. Epub 2019 Feb 4.

Department of Plastic Surgery and Burn Unit, King Fahad Military Medical Complex, Dammam, Saudi Arabia.

To share our experience with the management of Fournier gangrene (FG) using the bagging technique of the testes, and to highlight the importance of implementing a multidisciplinary approach in managing FG. A 58-year-old male with type 2 diabetes mellitus (DM) was brought to the emergency department (ED) with necrotizing fasciitis involving the genitalia; he was managed in the ED with Intravenous (IV) fluid resuscitation and IV antibiotics. The surgical team was consulted and multiple debridement procedures were done. Read More

BMJ Case Rep 2019 Mar 1;12(3). Epub 2019 Mar 1.

Otolaryngology Head and Neck Surgery, Saint Barnabas Medical Center, Livingston, New Jersey, USA.

Cervical necrotising fasciitis (NF) is an aggressive polymicrobial infection of the subcutaneous tissues in the head and neck. We present a case of a healthy 19-year-old man who developed cervical and upper mediastinal NF after an initial presentation of infectious mononucleosis (IM). He was treated with broad-spectrum antibiotics in addition to incision and drainage of an anterior neck and upper mediastinal abscess. Read More

Case Rep Ophthalmol Med 2019 20;2019:4534153. Epub 2019 Jan 20.

Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del S. Cuore, Rome, Italy.

Necrotizing fasciitis (NF) is a rare infection that spreads rapidly along the subcutaneous soft tissue planes. NF rarely involves the periorbital region due to the excellent blood supply of this region. We report a case of periorbital necrotising fasciitis following herpes zoster (HZ) in an immunocompromised 70-year-old patient with a dramatically rapid evolution into septic shock. Read More

ANZ J Surg 2019 Feb 21. Epub 2019 Feb 21.

Department of General Surgical Specialties, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.

Int Wound J 2019 Feb 19. Epub 2019 Feb 19.

Reading Hospital, Tower Health System, West Reading, Pennsylvania.

Negative pressure wound therapy with instillation and dwell time (NPWTi-d) is an automated system used to deliver, dwell, and remove topical solutions from the wound bed. Recently, a reticulated open cell foam dressing with through holes (ROCF-CC) was developed, which assists with wound cleansing by removing thick exudate and infectious materials. We present our experience using NPWTi-d with ROCF-CC on complex wounds when complete surgical debridement was inappropriate because of medical instability, recurrent non-viable tissue, or palliative treatment plan. Read More

J Surg Res 2019 Feb 12;238:119-126. Epub 2019 Feb 12.

Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington; Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington.

Background: The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score may distinguish necrotizing soft tissue infection (NSTI) from non-NSTI. The association of higher preoperative LRINEC scores with escalations of intraoperative anesthesia care in NSTI is unknown and may be useful in communicating illness severity during patient handoffs.

Materials And Methods: We conducted a retrospective cohort study of first operative debridement for suspected NSTI in a single referral center from 2013 to 2016. Read More

J Eur Acad Dermatol Venereol 2019 Feb 15. Epub 2019 Feb 15.

Department of Dermatology, Hospital General Universitario de Valencia, Valencia, Spain.

mSphere 2019 02 13;4(1). Epub 2019 Feb 13.

Tropical Diseases, Murdoch Children's Research Institute, Melbourne, Victoria, Australia

Group A (GAS) is a major cause of global infection-related morbidity and mortality. A modern controlled human infection model (CHIM) of GAS pharyngitis can accelerate vaccine development and pathogenesis research. A robust rationale for strain selection is central to meeting ethical, scientific, and regulatory requirements. Read More

ANZ J Surg 2019 Jan;89(1-2):E49

General and Digestive Surgery Department, University Hospital Virgen del Rocío, Seville, Spain.

J Infect Chemother 2019 Feb 7. Epub 2019 Feb 7.

Department of Immunology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, 162-8640, Tokyo, Japan. Electronic address:

Objectives: β-Hemolytic streptococci occasionally cause severe infections such as necrotizing fasciitis and streptococcal toxic shock syndrome (STSS). Here, we conducted a prospective study to investigate the production of cytokines and chemokines in patients with STSS to explore its pathogenesis in survivors and fatal cases.

Methods: From January 2013 through August 2015, all culture results from normally sterile sites were prospectively followed and screened for STSS. Read More

J Formos Med Assoc 2019 Feb 6. Epub 2019 Feb 6.

Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital, College of Medicine, Taipei, Taiwan. Electronic address:

Background: Necrotizing fasciitis (NF) is a life-threatening soft tissue infection with low incidence that requires prompt surgery. In the initial stage, it is difficult to distinguish NF and cellulitis, and limited population-based reports are available.

Methods: We queried inpatient data sets of National Health Institute Research Database in Taiwan from 2002 to 2011 for all patients with diagnoses of NF. Read More

BMC Genomics 2019 Feb 8;20(1):123. Epub 2019 Feb 8.

Center for Human Genetics, 1000 North Oak Avenue # MLR, Marshfield, WI, 54449, USA.

Background: We describe the virulence factors of a methicillin-sensitive Staphylococcus aureus sequence type (ST) 45 strain, MCRF184, (spa type t917), that caused severe necrotizing fasciitis in a 72-year-old diabetic male. The genome of MCRF184 possesses three genomic islands: a relatively large type III νSaα with 42 open reading frames (ORFs) that includes superantigen- and lipoprotein-like genes, a truncated νSaβ that consists mostly of the enterotoxin gene cluster (egc), and a νSaγ island with 18 ORFs including α-toxin. Additionally, the genome has two phage-related regions: phage φSa3 with three genes of the immune evasion cluster (IEC), and an incomplete phage that is distinct from other S. Read More

Arch Soc Esp Oftalmol 2019 Feb 4. Epub 2019 Feb 4.

Servicio de Oftalmología, Hospital Universitari i Politècnic La Fe, Avinguda de Fernando Abril Martorell 106, 46026, Valencia, España.

An 80 year-old woman with no relevant medical history, consulted for worsening of right palpebral itching and pain after an insect bite. Her eyelids had areas of laceration due to scratching, which rapidly progressed to fibrinoid necrosis over the first 24hours. Lesions were cultivated, revealing Streptococcus pyogenes and Staphylococcus aureus. Read More

Surg Infect (Larchmt) 2019 Feb 4. Epub 2019 Feb 4.

1 Department of Pharmacy and The Ohio State University Wexner Medical Center, Columbus, Ohio.

Background: Necrotizing soft-tissue infection (NSTI) is a devastating disease associated with high rates of morbidity and mortality. Hyperglycemia is associated with poor wound healing; however, there are no studies evaluating glycemic control outcomes in patients with NSTI. The objective of this study was to examine disease progression and death in patients with NSTI who achieved early glycemic control (EGC) compared with patients that did not. Read More

Acta Biomed 2018 12 14;90(1-S):162-168. Epub 2018 Dec 14.

Clinica Ortopedica dell'Università degli Studi di Brescia.

Necrotizing Fasciitis is a rare life-threatening infection , usually polymicrobial, that frequently affects the extremities in as many as two thirds of the cases. It typically involves primarily the muscular fascia, and then spreads through muscular and subcutaneous tissues. The early diagnosis may be challenging , and appears to be crucial in the management of this condition. Read More

Diagn Microbiol Infect Dis 2019 Jan 4. Epub 2019 Jan 4.

Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea. Electronic address:

This study aimed to characterize patients with monomicrobial gram-negative necrotizing fasciitis in three university hospitals in Korea. In this study, of the 115 patients with community-acquired necrotizing fasciitis, 67 (58%) had monomicrobial infections: 31 (27%) in the gram-negative group and 36 (31%) in the gram-positive group. The majority of patients in the gram-negative group were infected with Escherichia coli followed by Klebsiella pneumoniae and Vibrio vulnificus. Read More

Medicine (Baltimore) 2019 Feb;98(5):e14443

Int J Infect Dis 2019 Jan 25;81:73-80. Epub 2019 Jan 25.

Department of Orthopedic Surgery, Chang Gung Memorial Hospital at Chia-Yi, Taiwan, Republic of China; College of Medicine, Chang Gung University at Taoyuan, Taiwan, Republic of China.

Background: Vibrio vulnificus, Aeromonas hydrophila, methicillin-resistant Staphylococcus aureus (MRSA), group A Streptococcus, and group B Streptococcus are commonly detected causative agents of necrotizing fasciitis (NF) in Chia-Yi Chang Gung Memorial Hospital. The aim of this study was to develop and evaluate a multiplex PCR method for the simultaneous detection of five of the most important human pathogens involved in NF by using a novel combination of species-specific genes.

Methods: The samples used were collected from 99 patients with surgically confirmed NF of the extremities who were hospitalized consecutively between June 2015 and November 2017. Read More

Exp Clin Transplant 2019 Jan 21. Epub 2019 Jan 21.

From Whittington Health, London, United Kingdom.

Liver transplant has occasionally been performed in the presence of congenital afibrinogenemia and has been rarely used to treat it. Historically, to safely manage coagulopathy during transplant, these patients have been administered a combination of fresh frozen plasma and cryoprecipitate. In this case report, we discuss the first reported use of recombinant fibrinogen to treat such a patient and the decision-making process considered to balance the thrombotic and hemorrhagic risks. Read More

SAGE Open Med Case Rep 2019 9;7:2050313X18823090. Epub 2019 Jan 9.

Department of Surgery, Arthur Davison Children's Hospital, Ndola, Zambia.

Snakebite envenomation is a life-threatening injury and a neglected public health issue in Africa. We report the case of a child that presented 6 days following a forearm snakebite with compartment syndrome and necrotizing fasciitis of the upper limb extending to the neck and chest who developed mediastinitis. She underwent multiple surgical debridements and the mediastinitis was managed non-surgically with antibiotics and postural drainage leading to recovery. Read More

J Clin Invest 2019 Feb 22;129(2):516-517. Epub 2019 Jan 22.

Necrotizing fasciitis and myositis caused by group A streptococci (GAS) are among the most fulminating infections, with a mortality rate of 20% to 30%. Although numerous regimens have been utilized in attempts to control these devastating infections, such as combinations of various antimicrobial agents and intravenous immunoglobulin (IVIG) as well as hyperbaric oxygen therapy, none have been the complete answer. Zhu and colleagues have utilized a transposon-directed insertion-site sequencing (TraDIS) protocol to identify 126 genes of M1 and 116 genes of M28 strains of GAS required for myositis, of which 25% encode transporters, which could be used as possible targets for future therapeutic protocols. Read More

J Clin Invest 2019 Feb 22;129(2):887-901. Epub 2019 Jan 22.

Center for Molecular and Translational Human Infectious Diseases Research, Houston Methodist Research Institute, and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas, USA.

Necrotizing fasciitis and myositis are devastating infections characterized by high mortality. Group A streptococcus (GAS) is a common cause of these infections, but the molecular pathogenesis is poorly understood. We report a genome-wide analysis using serotype M1 and M28 strains that identified GAS genes contributing to necrotizing myositis in nonhuman primates (NHP), a clinically relevant model. Read More

Microsurgery 2019 Mar 21;39(3):263-266. Epub 2019 Jan 21.

Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Fournier's gangrene is lethal necrotizing fasciitis that involves the perineum and external genitalia. We describe the case of a 52-year-old man with Fournier's gangrene who underwent reconstruction of an extensive perineoscrotal defect using three pedicled perforator flaps. Three debridement procedures resulted in a skin and soft tissue defect of 36 × 18 cm involving the perineum, scrotum, groin, medial thigh, buttocks, and circumferential perianal area and left the perforating arteries originating from these locations unavailable for reconstruction. Read More

BMJ Case Rep 2019 Jan 17;12(1). Epub 2019 Jan 17.

Internal Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

is a halophilic found globally. They are thought to be normal microbiome in the estuaries along the coasts associated with seawater and seashells. Infection usually results from consumption of raw oysters or shellfish or exposure of broken skin or open wounds to contaminated salt or brackish water. Read More

Plast Reconstr Surg Glob Open 2018 Dec 17;6(12):e1921. Epub 2018 Dec 17.

Department of Ophthalmology, Temple University Hospital, Philadelphia, Pa.

Periocular necrotizing fasciitis is a rare, but potentially blinding, or even fatal disease. The authors report a case of a 44-year-old man who presented with quiescent bilateral periocular and facial necrotizing fasciitis. The patient was treated with antibiotics and surgical debridement, followed by negative-pressure wound therapy (NPWT), until the wound bed was thought to be healthy enough to support bilateral upper eyelid full-thickness skin grafts. Read More

J Clin Med 2019 Jan 16;8(1). Epub 2019 Jan 16.

Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.

The impact of diabetes on perioperative outcomes remains incompletely understood. Our purpose is to evaluate post-operative complications and mortality in patients with diabetes. Using the institutional and clinical databases of three university hospitals from 2009⁻2015, we conducted a matched study of 16,539 diabetes patients, aged >20 years, who underwent major surgery. Read More

Medicine (Baltimore) 2019 Jan;98(2):e13283

Residência Multiprofissional em Cuidados Continuados Integrados.

Rationale: Necrotizing fasciitis is a destructive tissue infection with rapid progression and high mortality. Thus, it is necessary that high-performance dressings be introduced as possibilities of treatment.

Patient Concerns: Female patient, 44 years of age, admitted to hospital unit complaining of lesion in the gluteal region and drainage of purulent secretion in large quantity followed by necrosis. Read More

Int J Low Extrem Wounds 2019 Jan 8:1534734618818685. Epub 2019 Jan 8.

1 Ruijin Hospital, Shanghai Jiaotong University, Shanghai, People's Republic of China.

Fournier's gangrene is a rare, rapidly progressing, and life-threatening infection associated with necrotizing fasciitis in the perineal, genital, and/or lower abdominal regions. Septic shock and multiple organ dysfunction syndrome due to the condition are even rarer events. We describe the case of a 58-year-old man who visited the emergency department with severely painful swelling in the scrotal, perianal, and lower abdominal regions. Read More

Cureus 2018 Oct 29;10(10):e3515. Epub 2018 Oct 29.

Wound, Ostomy, Continence Care / Nursing Administration, Reading Health System, Reading, USA.

The human body is a complex, multisystem organism that can manifest disease processes in a multitude of ways. Over the decades, technological advancements have allowed us to make precise diagnoses so that clinicians can thoroughly treat the underlying cause. Frequently these disease processes require surgical intervention to eliminate the progression and provide the patient with positive outcomes. Read More

Cureus 2018 Oct 23;10(10):e3483. Epub 2018 Oct 23.

Orthopedic Surgery, Queen's Medical Center, Honolulu, USA.

Necrotizing fasciitis is a rapidly spreading infection of the soft tissue, which carries significant morbidity and mortality. This condition is treated with broad-spectrum antibiotics, irrigation and surgical debridement of the affected area, and hemodynamic support. Negative pressure wound therapy (NPWT) has been utilized after surgical debridement to promote wound healing, especially when significant debridement has occurred. Read More

Am Surg 2018 Dec;84(12):e508-e509

BMJ Case Rep 2018 12 7;11(1). Epub 2018 Dec 7.

Department of Hematology and Oncology, Boston Medical Center, Boston, Massachusetts, USA.

We present a case of an unusual presentation of acute promyelocytic leukaemia (APML), which presented with Fournier gangrene (FG). A 38-year-old man presented with malaise, groin swelling, anal bleeding, fever and was found to have FG. Initial workup revealed pancytopaenia, borderline low fibrinogen, prolonged international normalized ratio (INR), which raised the suspicion for leukaemia. Read More

BMJ Case Rep 2018 Nov 28;11(1). Epub 2018 Nov 28.

Department of Otolaryngology - Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

An otherwise healthy 24-year-old man presented with 1 week of fever, facial pain and swelling. He initially sought care at an outside hospital, where he was diagnosed with folliculitis and sent home with oral antibiotics. On arrival at our institution, CT neck was ordered, which demonstrated diffuse submental phlegmon, prompting incision and drainage. Read More

BMJ Case Rep 2018 Nov 28;11(1). Epub 2018 Nov 28.

Section of Infectious Diseases, Department of Medicine, College of Medicine & Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.

A 48-year-old man presented with a non-healing wound on his left foot after stepping on a nail. He self-medicated with amoxicillin, but the wound progressed prompting consult. On examination, his left foot was diffusely swollen with surrounding erythema, areas of gangrene, foul-smelling purulent discharge and subcutaneous emphysema. Read More

Clin Nucl Med 2019 Mar;44(3):251-254

Department of Pathology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

Focal myositis is an uncommon inflammatory pseudotumor of the skeletal muscle that may mimic neoplastic and inflammatory diseases. We present one case of focal myositis involving the left proximal vastus lateralis and vastus intermedius, and left soleus showing intense FDG uptake on FDG PET/CT. This case indicates that focal myositis should be considered as a differential diagnosis in patients with focal hypermetabolic muscular lesions, including benign and malignant tumors, necrotizing autoimmune myopathy, nodular fasciitis, myositis ossificans, and muscular sarcoidosis. Read More

Wounds 2018 Dec;30(12):E116-E120

Department of Surgery, NYU Winthrop Hospital, Mineola, NY.

Introduction: Necrotizing myositis (NM) is an extremely rare necrotizing soft tissue infection involving muscle. Unlike similar infections (eg, necrotizing fasciitis, clostridial myonecrosis) that can be more readily diagnosed, NM can have a benign presentation then rapidly progress into a life-threatening condition with a mortality rate of 100% without surgical intervention.

Case Report: A 74-year-old man with a history of prostate cancer with radiation therapy, seed implants, and 2 transurethral resection procedures presented to the emergency department after a fall. Read More

Jpn J Med (Lond) 2018 ;1(6):269-275

Department of Microbiology and Immunology, Montana State University, Bozeman, MT 59718, USA.

Group A (GAS) causes common pharyngitis and skin infections and occasional severe invasive infections. This review describes the recent progress on the pathogenesis of hypervirulent GAS. CovRS mutations are frequent among invasive GAS isolates and lead to hypervirulence. Read More

Infez Med 2018 Dec;26(4):359-363

Laboratory Medicine, San Bassiano Hospital, AULSS 7 Pedemontana, Bassano del Grappa, Italy.

Diabetes mellitus is one of the serious conditions associated with necrotizing fasciitis, a severe bacterial skin infection that spreads quickly and is characterized by extensive necrosis of the deep and superficial fascia resulting in devascularization and necrosis of the associated tissues. In addition to debridement and aggressive surgery procedures, the effectiveness of therapy depends on choosing the appropriate antibacterial agents. Hence the key to successful management is an early and accurate diagnosis. Read More

ANZ J Surg 2018 Dec 9. Epub 2018 Dec 9.

Department of Plastic and Reconstructive Surgery, Peninsula Health, Melbourne, Victoria, Australia.