{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T02:11:41Z","timestamp":1760667101725,"version":"build-2065373602"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T00:00:00Z","timestamp":1753056000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T00:00:00Z","timestamp":1753056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006451","name":"Hospices Civils de Lyon","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006451","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Legal Med"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Necrotizing fasciitis (NF) is a serious life-threatening condition characterized by rapidly progressing tissue necrosis. It is associated with a high mortality rate, reaching up to 80% in some cases. Few cases of necrotizing fasciitis as a complication of casting have been reported, and most of these occurred in the orthopedic setting. The present article reports the case of a patient who developed necrotizing fasciitis following the placement of a cast and who was undiagnosed clinically. Due to the aggressive nature of the infection, the patient died shortly after the initial complaint and the case was presented to the forensic team for further evaluation by autopsy. Although cases of necrotizing fasciitis following cast application have been published in the literatures, no cases have been described within the forensic medicine setting. This is the first autopsy case report discussing this condition in a forensic medicine context, underscoring the novelty of this report. Our objective is to emphasize the importance of an early recognition of this devastating infection to avoid undesirable outcomes. Necrotizing fasciitis needs to be considered in patients with casts, particularly when presenting with pain out of proportion compared to the physical findings. The detailed autopsy findings along with the pathological and microbiological findings are also highlighted here to help forensic doctors and pathologists recognize this type of infection when encountered.<\/jats:p>","DOI":"10.1007\/s00414-025-03548-5","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T02:19:48Z","timestamp":1753064388000},"page":"2799-2806","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Necrotizing fasciitis in a plaster casted upper extremity: a forensic autopsy case report"],"prefix":"10.1007","volume":"139","author":[{"given":"Ahed","family":"Alghaithi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie","family":"Epain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne-sohphie","family":"Advenier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurent","family":"Fanton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,7,21]]},"reference":[{"key":"3548_CR1","doi-asserted-by":"publisher","unstructured":"Agarwal L, Yasin A Necrotising fasciitis: a fatal case of sepsis and a diagnostic challenge\u2013 case report and review of literature. Int J Emerg Med. 2018 Dec [cited 2024 Jul 28];11(1):23. Available from: https:\/\/intjem.biomedcentral.com\/articles\/https:\/\/doi.org\/10.1186\/s12245-018-0183-x","DOI":"10.1186\/s12245-018-0183-x"},{"key":"3548_CR2","doi-asserted-by":"publisher","unstructured":"Naqvi G, Malik S, Jan W Necrotizing Fasciitis of the lower extremity: a case report and current concept of diagnosis and management. Scand J Trauma Resusc Emerg Med. 2009 [cited 2024 Jul 28];17(1):28. Available from: http:\/\/sjtrem.biomedcentral.com\/articles\/https:\/\/doi.org\/10.1186\/1757-7241-17-28","DOI":"10.1186\/1757-7241-17-28"},{"key":"3548_CR3","doi-asserted-by":"crossref","unstructured":"Delasobera BE, Place R, Howell J, Davis JE Serious Infectious Complications Related to Extremity Cast\/Splint Placement in Children. J Emerg Med. 2011 Jul [cited 2024 Jul 28];41(1):47\u201350. Available from: https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0736467910004051","DOI":"10.1016\/j.jemermed.2010.05.031"},{"key":"3548_CR4","doi-asserted-by":"crossref","unstructured":"Elliott D, Kufera JA, Myers RAM The microbiology of necrotizing soft tissue infections. Am J Surg. 2000 May [cited 2024 Jul 29];179(5):361\u20136. Available from: https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0002961000003603","DOI":"10.1016\/S0002-9610(00)00360-3"},{"key":"3548_CR5","doi-asserted-by":"crossref","unstructured":"Suadoni F, Gioia S, Tiri B, Mencacci A, Vento S, Lancia M A unique autopsy case of spontaneous necrotizing soft tissue infection of the chest-wall in a healthy adult without major risk factors. Forensic Sci Int Rep. 2020 Dec [cited 2024 Jul 28];2:100113. Available from: https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2665910720300621","DOI":"10.1016\/j.fsir.2020.100113"},{"key":"3548_CR6","doi-asserted-by":"publisher","unstructured":"Goldstein EJC, Anaya DA, Dellinger EP Necrotizing Soft-Tissue Infection: Diagnosis and Management. Clin Infect Dis. 2007 Mar 1 [cited 2024 Jul 28];44(5):705\u201310. Available from: https:\/\/academic.oup.com\/cid\/article-lookup\/doi\/https:\/\/doi.org\/10.1086\/511638","DOI":"10.1086\/511638"},{"key":"3548_CR7","doi-asserted-by":"crossref","unstructured":"Edlich RF, Cross CL, Dahlstrom JJ, Long WB Modern Concepts of the Diagnosis and Treatment of Necrotizing Fasciitis. J Emerg Med. 2010 Aug [cited 2024 Jul 28];39(2):261\u20135. Available from: https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0736467908006197","DOI":"10.1016\/j.jemermed.2008.06.024"},{"key":"3548_CR8","doi-asserted-by":"crossref","unstructured":"Tarricone A, Mata KDL, Gee A, Axman W, Buricea C, Mandato MG et al A Systematic Review and Meta-Analysis of the Effectiveness of LRINEC Score for Predicting Upper and Lower Extremity Necrotizing Fasciitis. J Foot Ankle Surg. 2022 Mar [cited 2024 Jul 28];61(2):384\u20139. Available from: https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1067251621003495","DOI":"10.1053\/j.jfas.2021.09.015"},{"key":"3548_CR9","doi-asserted-by":"crossref","unstructured":"Netzer G, Fuchs BD (2009) Necrotizing Fasciitis in a Plaster-Casted Limb: Case Report. Am J Crit Care. May 1 [cited 2024 Jul 29];18(3):288\u2013287. Available from: https:\/\/aacnjournals.org\/ajcconline\/article\/18\/3\/288\/5713\/Necrotizing-Fasciitis-in-a-PlasterCasted-Limb-Case","DOI":"10.4037\/ajcc2009363"},{"key":"3548_CR10","doi-asserted-by":"crossref","unstructured":"Skacel C, Boyle M A five year review of anaerobic, necrotizing soft tissue infections: a nursing perspective. Aust Crit Care. 1992 Dec [cited 2024 Jul 29];5(4):15\u201320. Available from: https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1036731492700642","DOI":"10.1016\/S1036-7314(92)70064-2"}],"container-title":["International Journal of Legal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00414-025-03548-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00414-025-03548-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00414-025-03548-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T01:37:41Z","timestamp":1760665061000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00414-025-03548-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,21]]},"references-count":10,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["3548"],"URL":"https:\/\/doi.org\/10.1007\/s00414-025-03548-5","relation":{},"ISSN":["0937-9827","1437-1596"],"issn-type":[{"type":"print","value":"0937-9827"},{"type":"electronic","value":"1437-1596"}],"subject":[],"published":{"date-parts":[[2025,7,21]]},"assertion":[{"value":"17 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest. No funding was received to assist with the preparation of this manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Not applicable. According to the French law and ethical guidelines, autopsy case reports with no pending legal files can be published without consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}}]}}