Med Mal Infect 2017 Jul 19. Epub 2017 Jul 19.

Department of plastic reconstructive and aesthetic surgery, Amiens university hospital, hôpital Sud, Salouel, 80054 Amiens cedex 01, France. Electronic address:

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017 Jul;52(7):538-540

Department of Otorhniolaryngology, Tongji Hospital, Tongji MedicalUniversity, Shanghai 200065, China.

IDCases 2017 27;9:91-94. Epub 2017 Jun 27.

Department of Obstetrics & Gynaecology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia.

We report a fatal case of post-partum streptococcal toxic shock syndrome in a patient who was previously healthy and had presented to the emergency department with an extensive blistering ecchymotic lesions over her right buttock and thigh associated with severe pain. The pregnancy had been uncomplicated, and the mode of delivery had been spontaneous vaginal delivery with an episiotomy. She was found to have septicemic shock requiring high inotropic support. Read More

Eur Urol Focus 2016 Oct 19;2(4):453-459. Epub 2016 Feb 19.

Departments of Pediatrics and Medicine, Georgetown University School of Medicine, Washington, DC, USA. Electronic address:

Context: A growing body of evidence supports the health benefits of circumcision, but the occurrence of infectious complications is of concern.

Objective: To review literature presenting past data and studies of infectious complications of circumcision and their prevention.

Evidence Acquisition: A literature search was conducted of the Cochrane Library, Embase, Turning Research into Practice, PubMed, and Medline databases from their inception through June 25, 2015. Read More

PLoS One 2017 18;12(7):e0180757. Epub 2017 Jul 18.

Institute of Medical Microbiology and National Reference Center for Streptococci, University Hospital (RWTH), Aachen, Germany.

A nationwide laboratory-based surveillance study of invasive S. pyogenes infections was conducted in Germany. Invasive isolates (n = 719) were obtained between 2009 and 2014. Read More

J Pediatr Orthop 2017 Jul 17. Epub 2017 Jul 17.

*Department of Children's Orthopedics, Hospital for Children Munich-Schwabing, Munich †BG Trauma Center Murnau, Murnau, Germany.

Background: Postoperative pyoderma gangrenosum (PG) is a neutrophilic dermatosis and pathergic reaction at surgical sites. Reports of children with postoperative PG are rare in the literature.

Methods: We report the case of a 13-year-old boy without any known preexisting illnesses, who developed severe systemic response and wound deterioration after elective hip reconstruction surgery. Read More

Int J Low Extrem Wounds 2017 Jun 17;16(2):108-113. Epub 2017 Apr 17.

1 Department of Surgery, Faculty of Medicine, Chiang Mai University, Thailand.

Necrotizing fasciitis (NF) is a high morbidity and mortality disease and also demands high economic resources. The standard treatment of NF is surgical debridement and proper dressing for wound bed preparation. The efficacy of silver alginate dressing can inhibit the growth of microorganisms and keep the environment clean for wound bed preparation. Read More

Gen Dent 2017 Jul-Aug;65(4):25-29

Necrotizing fasciitis (NF) is a severe bacterial infection with rapid and aggressive progression. The infection generally affects individuals with comorbid conditions that lead to immunologic and microvascular deficiencies. It is characterized by necrosis of tissues, mainly in the extremities, trunk, and perineum, and is rarely found in the head and neck. Read More

Singapore Med J 2017 07 6. Epub 2017 Jul 6.

Department of Orthopaedic Surgery, National University Hospital, Singapore.

We present five patients with vibrio necrotising fasciitis, a lethal and disabling disease. Among our patients, two had a history of exposure to either warm seawater or raw/live seafood, three had underlying chronic liver disease, and four presented with hypotension and fever. There were three deaths and four patients required intensive care unit stay. Read More

Cureus 2017 May 29;9(5):e1283. Epub 2017 May 29.

Clinical Pathology, Wake Forest Baptist Medical Center.

Candida pararugosa is a yeast that has been previously isolated in various human specimens. The first reported isolation was from human feces in 1998, with subsequent reports of positive cultures from the oral cavity where it was thought to represent colonization rather than true infection. Though it has been isolated from other human sites, its clinical significance and manifestations are poorly characterized. Read More

Intern Med 2017 1;56(13):1755-1756. Epub 2017 Jul 1.

Department of General Internal Medicine, Saitama Medical University, Japan.

Dan Med J 2017 Jul;64(7)

Necrotising soft tissue infection (NSTI) is a life-threatening and rapidly progressing bacterial infection involving one or more layers of the soft tissue compartments causing necrosis. The amputation and mortality rates remain high despite increased focus on the patients. Timely treatment, including surgical intervention, reduces the risk of severe disability and death. Read More

Euro Surveill 2017 Jun;22(23)

Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.

In March 2017, a patient with necrotising fasciitis caused by Neisseria meningitidis serogroup W (MenW) clonal complex 11 was diagnosed in the Netherlands. Unusual and severe presentations of MenW infections are common in the current European epidemic. In the Netherlands, the incidence of MenW infections increased 10-fold, from an average of 0. Read More

J Am Podiatr Med Assoc 2017 May;107(3):231-239

Serratia marcescens is a ubiquitous, facultatively anaerobic, gram-negative bacillus that has been cited to cause infection in immunocompromised populations. In the literature, S marcescens infections of the lower extremity have presented as granulomatous ulceration, abscess, bullous cellulitis, and necrotizing fasciitis. Herein we present a series of three cases of lower-extremity infections in which S marcescens was the sole or a contributing pathogen. Read More

Infect Dis (Lond) 2017 Jun 23:1-7. Epub 2017 Jun 23.

b Department of Otorhinolaryngology Head and Neck Surgery , Regionshospitalet Holstebro HEV , Holstebro , Denmark.

Background: Necrotizing fasciitis in the head and neck (NF-HN) is a rare and potentially life-threatening condition. The use of hyperbaric oxygen therapy (HBOT) in the acute regimen is disputed and there is a lack of evidence of therapeutic effect. This study aims to describe a retrospective cohort of patients with NF-HN and investigate the use of HBOT and consequences thereof. Read More

Rev Esp Cir Ortop Traumatol 2017 Jul - Aug;61(4):265-272. Epub 2017 Jun 20.

Servicio de Infecciones, Hospital Clínic de Barcelona, Barcelona, España.

Aim: To describe mortality and complications of patients seen in the emergency room, diagnosed with necrotizing soft tissue infection (NSTI) and the correlation of such complications with the Laboratory Risk Indicator for Necrotizing fasciitis scale (LRINEC).

Methods: Retrospective observational study including patients with a diagnosis of NSTI in the emergency room of a tertiary hospital over 7 years. The results are shown as median, interquartile range and absolute range for quantitative variables. Read More

Int J Surg Case Rep 2017 Jun 8;37:41-44. Epub 2017 Jun 8.

Alabama College of Osteopathic Medicine, Class of 2018, 445 Health Science Blvd., Dothan, AL 36303, USA.

Introduction: An obturator hernia is an uncommon form of abdominal hernia that is difficult to diagnose due to its non-distinct presentation. This case investigates an emergency treatment of an obturator hernia presenting in a patient with an ipsilateral hip disarticulation in a 266-bed community hospital.

Presentation Of Case: A 53-year old man with a history of a left hip disarticulation 3-weeks prior presented to the emergency department with fever, nausea, vomiting, and diarrhea for the past 5-days. Read More

Vasc Endovascular Surg 2017 Aug 15;51(6):408-412. Epub 2017 Jun 15.

6 Intensive Care Unit, University Hospital of Nice, Nice, France.

Descending necrotizing mediastinitis (DNM) is a life-threatening disease which often develops from a purulent infection of the oral cavity and is associated with high rates of mortality. Here we report the case of a young patient who died from an aortic arch rupture in context of DNM developed from an odontogenic infection caused by Prevotella buccae. Based on the current knowledge on this very rare vascular complication, we discuss factors that may have contributed to this fatal issue and future issues to optimize care provided to patients. Read More

FEBS J 2017 Jun 15. Epub 2017 Jun 15.

Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA.

Streptococcus pyogenes, also known as Group A Strep (GAS), is an obligate human pathogen that is responsible for millions of infections and numerous deaths per year. Infection manifestations can range from simple, acute pharyngitis to more complex, necrotizing fasciitis. To date, most treatments for GAS infections involve the use of common antibiotics including tetracycline and clindamycin. Read More

Rev Bras Ter Intensiva 2017 Jun 12. Epub 2017 Jun 12.

Serviço de Moléstias Infecciosas, Centro Hospitalar de São João - Porto, Portugal.

Objective:: To identify factors that may influence outcomes in patients with severe skin and soft tissue infections in the intensive care unit.

Methods:: A retrospective observational study was conducted in a cohort of 1,123 critically ill patients admitted to an intensive care unit with a primary or secondary diagnosis of severe skin and soft tissues infection between January 2006 and December 2014.

Results:: Thirty patients were included, 20 (66. Read More

West J Emerg Med 2017 Jun 12;18(4):684-689. Epub 2017 May 12.

Arrowhead Regional Medical Center, Department of Emergency Medicine, Colton, California.

Introduction: Necrotizing fasciitis (NF) is an uncommon but rapidly progressive infection that results in gross morbidity and mortality if not treated in its early stages. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score is used to distinguish NF from other soft tissue infections such as cellulitis or abscess. This study analyzed the ability of the LRINEC score to accurately rule out NF in patients who were confirmed to have cellulitis, as well as the capability to differentiate cellulitis from NF. Read More

BMC Infect Dis 2017 Jun 12;17(1):418. Epub 2017 Jun 12.

Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Old Road Campus, University of Oxford, Oxford, OX3 7BN, UK.

Background: Cellulitis is a common infection of the skin and subcutaneous tissues. It is associated with significant morbidity from necrosectomies and amputations especially in sub-Saharan Africa. We aimed at identifying the risk factors and burden of lower limb cellulitis to inform preventive strategies in Cameroon. Read More

Eur J Obstet Gynecol Reprod Biol 2017 Aug 1;215:33-40. Epub 2017 Jun 1.

Aarhus University Hospital, Department of Obstetrics and Gynecology(,) Aarhus, Denmark.

Group A streptococci infection has re-emerged since the 1980s and onward, despite the awareness of the etiology and the use of penicillin. It now accounts for more than 75,000 deaths worldwide every year. Postpartum women have a 20-fold increased incidence of group A streptococci disease compared to non-pregnant women. Read More

Case Rep Obstet Gynecol 2017 16;2017:9763470. Epub 2017 May 16.

Gynaeco-Obstetric and Paediatric Hospital and Department of Surgery, University Teaching Hospital, Yaoundé, Cameroon.

Necrotising fasciitis is a rare but potentially lethal condition in obstetrics which usually presents with fulminant tissue destruction and a resultant high mortality. We report a 19-year-old Sub-Saharan female diagnosed with a rapidly erosive necrotising fasciitis on day 5 after caesarean section in a resource-limited setting. Timely diagnosis, aggressive antibiotic therapy, and prompt surgical intervention via an extensive abdominal wall debridement were pivotal to her survival. Read More

Medicine (Baltimore) 2017 Jun;96(23):e6908

Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.

Rationale: Necrotizing fasciitis (NF) is defined as a rare, life-threatening, rapidly spreading soft tissue infection resulting from a polymicrobial origin, with a predominance of anaerobic organisms that presents with necrosis of the muscle, fascia, and surrounding soft tissue.

Patient Concerns And Diagnoses: A 64-year-old male who sustained tibia fracture caused by falling from a height underwent a tibia surgery with minimally invasive plate osteosynthesis technique in another institution. Postoperatively, the patient had development of a very uncommon NF at the site of the tibia procedure. Read More

Ann Hematol 2017 Aug 7;96(8):1415-1416. Epub 2017 Jun 7.

Department of Hematology and Hematology Research Laboratory, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.

J Ayub Med Coll Abbottabad 2016 Oct-Dec;28(4):680-682

Department of General Surgery, Nobel Medical College Teaching Hospital and Research Centre, Biratnagar, Nepal.

Background: Necrotizing fasciitis (NF) is a serious and potentially fatal condition where there is rapid progression of inflammation of skin, subcutaneous tissue, and superficial fascia and can be mono-microbial or poly-microbial. The disease is rapidly progressive in nature and if not promptly treated leads to significant morbidity or even mortality. This study was designed to explore the various risk factors commonly present and study the outcome of the disease. Read More

Transplant Proc 2017 Jun;49(5):1189-1191

Department of Nephrology, Inha University Hospital, Incheon, Korea.

Introduction: Necrotizing fasciitis is an uncommon soft-tissue infection that involves the superficial fascia, subcutaneous fat, and deep fascia. Herein, we report the first case of Enterobacter cloacae-related necrotizing fasciitis after peritoneal dialysis in delayed graft function.

Case: A 58-year-old man, who was a hepatitis B-viral carrier and had atrial fibrillation, received cadaveric renal transplantation with peritoneal dialysis and encountered delayed graft function. Read More

Intern Med 2017 1;56(11):1439-1442. Epub 2017 Jun 1.

Department of General Internal Medicine, Rakuwakai Otowa Hospital, Japan.

We herein report a case of acute carpal tunnel syndrome due to pyogenic flexor tenosynovitis in the absence of any antecedent injury whose rapid progression and course was similar to that seen with necrotizing fasciitis. This potentially disastrous clinical condition must be promptly recognized, since it needs early surgical management to prevent morbidity. Read More

Malays Orthop J 2016 Nov;10(3):39-41

Department of Orthopaedic Surgery, Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, Bandar Seri Begawan, Brunei Darussalam.

Subcutaneous emphysema is the presence of gas or air in the subcutaneous tissue plane. The term is generally used to describe any soft tissue emphysema of the body wall or limbs, it can result from benign causes, most commonly secondary to trauma or from a life-threatening infection by gas gangrene or necrotising fasciitis. A case of subcutaneous emphysema involving the upper limb resulting from a trivial laceration to the elbow is reported and the importance of distinguishing between the two causes of subcutaneous emphysema is highlighted. Read More

Dermatol Online J 2017 Apr 15;23(4). Epub 2017 Apr 15.

Medical Scientist Training Program, Ohio State University Wexner Medical Center, Columbus, Ohio, Department of Internal Medicine, Division of Dermatology, Ohio State University Wexner Medical Center, Columbus, Ohio.

Necrotizing fasciitis is a serious infection of the skin and soft tissues. Pasteurella multocida is rarely reported to cause necrotizing fasciitis and is associated with high mortality. We describe a female patient with a past medical history of diabetes mellitus and myeloproliferative disorder presenting with bullae and erythema of the right forearm secondary to P. Read More

APSP J Case Rep 2017 May-Jun;8(3):23. Epub 2017 May 1.

Department of Paediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh.

CMAJ 2017 May;189(20):E721-E723

Section of Plastic Surgery, Department of Surgery, University of Manitoba, Winnipeg, Man.

Burns 2017 May 20. Epub 2017 May 20.

Manitoba Firefighters' Burn Unit, Health Sciences Centre, Winnipeg, Manitoba, Canada; Section of Plastic Surgery, Department of Surgery, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; Section of General Surgery, Department of Surgery, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address:

Background: Necrotizing fasciitis (NF) is a life-threatening infection requiring extensive debridement that may necessitate amputation. Free tissue transfer (FTT) is an option for reconstruction in difficult cases. Currently, only case reports have described FTT in the setting of NF, and comprehensive evidence on flap outcomes is lacking. Read More

Case Rep Nephrol 2017 26;2017:7240156. Epub 2017 Apr 26.

Department of Infectious Disease, Maimonides Medical Center, Brooklyn, NY, USA.

A 43-year-old male patient with past medical history of diabetes mellitus (DM), end stage renal disease (ESRD) on hemodialysis (HD), congestive heart failure (CHF), obstructive sleep apnea (OSA), and chronic anemia presented with complaints of left thigh pain. A computerized tomogram (CT) of the thigh revealed evidence of edema with no evidence of a focal collection or gas formation noted. The patient's clinical symptoms persisted and he underwent magnetic resonance imaging (MRI) of his thigh which was reported to show small areas of muscle necrosis with fluid collection. Read More

Emerg Radiol 2017 May 18. Epub 2017 May 18.

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore.

Patients presenting with a painful swollen leg are not infrequently encountered at the emergency department and can pose a diagnostic dilemma for attending physicians. The potential causes of leg pain and swelling include trauma, infection, inflammation, and neurogenic, vascular, and iatrogenic conditions; with magnetic resonance imaging (MRI) being an important tool in evaluation. We describe the MRI features of various conditions causing painful swollen legs. Read More

J Orthop Case Rep 2016 Nov-Dec;6(5):73-75

Department of Orthopaedics, V. S. Hospital, and N. H. L. Medical College, Ahmedabad, India.

Introduction: Plasters have been frequently associated with known complications such as infection, and compartment syndrome or deep vein thrombosis. However, life-threatening complication of necrotizing fasciitis (NF) has not been frequently attributed to plaster.

Case Report: We had a case of a 62-year male developing a lethal NF triggered by a below knee plaster for undisplaced fracture medial malleolus after twisting injury. Read More

Cureus 2017 Apr 14;9(4):e1168. Epub 2017 Apr 14.

Department of Emergency Medicine, University of Arizona.

Necrotizing fasciitis is a devastating infectious disease process that is characterized by extensive soft tissue necrosis along deep fascial planes, systemic toxicity, and high mortality. Ultrasound imaging is a rapid and non-invasive tool that can be used to help make the diagnosis of necrotizing fasciitis by identifying several distinctive sonographic findings. The purpose of this study is to describe the construction of a realistic diagnostic training model for necrotizing fasciitis using fresh frozen cadavers and common, affordable materials. Read More

Eur J Trauma Emerg Surg 2017 May 8. Epub 2017 May 8.

Department of Trauma, Hand, and Reconstructive Surgery, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.

Background: Necrotizing fasciitis is a life-threatening soft tissue infection characterized by a rapid spreading infection of the subcutaneous tissue and in particular the fascia. The management of infected tissues requires a rapid diagnosis, immediate aggressive surgical management and an extended debridement. In some cases early amputations of the affected tissues and maximum intensive care treatment, in case of sepsis, are required. Read More

Ann Med Health Sci Res 2016 Jul-Aug;6(4):251-256

Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.

Necrotizing fasciitis was recognized centuries ago by physicians. It is a rapidly progressive and potentially fatal soft-tissue infection that is typified by soft-tissue necrosis, especially affecting the subcutaneous tissues and fascia. Cervico-facial necrotizing fasciitis is said to be uncommon, but when it occurs, it is often of odontogenic origin and has severe consequences if not promptly treated. Read More

J Mycol Med 2017 May 4. Epub 2017 May 4.

Department of Plastic Surgery, Hand Surgery and Burn Center, Faculty of Medicine, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany.

We present a fatal case of Aspergillus-associated lung failure in a patient with necrotizing fasciitis. The cause of the fasciitis was a retroperitoneal perforation of a colon carcinoma. Being already a rare condition, the fasciitis did not manifest as Fournier's gangrene like similar described cases illustrate, but instead travelled along the fasciae and subcutaneous fat tissue cranially into the thoracic cavity, ultimately leading to a disseminated infection of the lungs. Read More

Int J Surg Case Rep 2017 18;35:103-105. Epub 2017 Apr 18.

Department of Surgery - Division of General, Minimally Invasive & Robotic Surgery, University of Illinois at Chicago, 840 S. Wood Street, Suite 435E (M/C958), Chicago, IL 60612, USA. Electronic address:

Introduction: Necrotizing fasciitis (NF), a necrotizing infection of the soft tissue, is a medical emergency usually occurring in the lower extremities and abdominal regions and often difficult to diagnose promptly.

Presentation Of Case: This case report looks at one atypical presentation of NF with the unusual location of the vulva and no known associated comorbidities or risk factors.

Discussion: Diagnosing this patient was particularly difficult due to the inconsistent clinical, laboratory and imaging findings. Read More

J Cutan Med Surg 2017 May 1:1203475417708164. Epub 2017 May 1.

4 University of Missouri Kansas City, Department of Internal Medicine, Kansas City, MO, USA.

Acute cutaneous necrosis is characterised by a wide range of aetiologies and is associated with significant morbidity and mortality, warranting complex considerations in management. Early recognition is imperative in diagnosis and management of sudden gangrenous changes in the skin. This review discusses major causes of cutaneous necrosis, examines the need for early assessment, and integrates techniques related to diagnosis and management. Read More

Open Forum Infect Dis 2017 4;4(2):ofx042. Epub 2017 Mar 4.

Public Health Ontario, Toronto, Canada.

Background: Invasive group A Streptococcus (iGAS) disease caused by type emm89 strains has been increasing worldwide, driven by the emergence of an epidemic clonal variant (clade 3 emm89). The clinical characteristics of patients with emm89 iGAS disease, and in particular with clade 3 emm89 iGAS disease, are poorly described.

Methods: We used population-based iGAS surveillance data collected in metropolitan Toronto, Ontario, Canada during the period 2000-2014. Read More

Eur J Dermatol 2017 Jun;27(3):326-328

Department of Dermatology, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga 520-2192, Japan.

Ann R Coll Surg Engl 2017 May;99(5):341-346

Queen Elizabeth Hospital, Edgbaston, Birmingham, UK.

Introduction Early operative debridement of necrotising fasciitis is a major outcome determinant. Identification and diagnosis of such patients can be clinically difficult. The Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) score first published in 2004 is based on routinely performed parameters and offers a method for identifying early cases. Read More

PeerJ 2017 27;5:e3226. Epub 2017 Apr 27.

Respiratory and Vaccine Preventable Bacterial Reference Unit, Public Health England, London, United Kingdom.

Streptococcus pyogenes group A Streptococcus (GAS) is the most common cause of bacterial throat infections, and can cause mild to severe skin and soft tissue infections, including impetigo, erysipelas, necrotizing fasciitis, as well as systemic and fatal infections including septicaemia and meningitis. Estimated annual incidence for invasive group A streptococcal infection (iGAS) in industrialised countries is approximately three per 100,000 per year. Typing is currently used in England and Wales to monitor bacterial strains of S. Read More

J Surg Case Rep 2017 Apr 20;2017(4):rjx065. Epub 2017 Apr 20.

Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong.

Background: This report presents an immunocompetent lady suffering from Candida parapsilosis associated with polybacterial cervical necrotizing fasciitis and descending mediastinitis. A literature review and management of invasive candidiasis is discussed.

Methods: A 57-year-old healthy lady presented with cervical necrotizing fasciitis and descending mediastinitis. Read More

BMJ Case Rep 2017 Apr 29;2017. Epub 2017 Apr 29.

Department of Intensive Care, Gelderse Vallei Hospital, Ede, The Netherlands.