{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T14:48:41Z","timestamp":1793976521270,"version":"4.8.0"},"reference-count":117,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jem-journal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Emergency Medicine"],"published-print":{"date-parts":[[2019,10]]},"DOI":"10.1016\/j.jemermed.2019.06.023","type":"journal-article","created":{"date-parts":[[2019,8,28]],"date-time":"2019-08-28T17:54:13Z","timestamp":1567014853000},"page":"488-500","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":68,"title":["Fournier Gangrene: A Review for Emergency Clinicians"],"prefix":"10.1016","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1361-5501","authenticated-orcid":false,"given":"Tim","family":"Montrief","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4770-8869","authenticated-orcid":false,"given":"Brit","family":"Long","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Koyfman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Auerbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jemermed.2019.06.023_bib1","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1067\/j.cpsurg.2014.06.001","article-title":"Necrotizing soft tissue infections: review and current concepts in treatment, systems of care, and outcomes","volume":"51","author":"Hakkarainen","year":"2014","journal-title":"Curr Probl Surg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib2","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.urology.2017.10.031","article-title":"Presentation and diagnosis of Fournier gangrene","volume":"114","author":"Voelzke","year":"2018","journal-title":"Urology"},{"key":"10.1016\/j.jemermed.2019.06.023_bib3","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1046\/j.1365-2168.2000.01497.x","article-title":"Fournier's gangrene: a review of 1726 cases","volume":"87","author":"Eke","year":"2000","journal-title":"Br J Surg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib4","first-page":"532","article-title":"Fournier's gangrene: our experience in 5 years, bibliographic review and assessment of the Fournier's gangrene severity index","volume":"62","author":"Morua","year":"2009","journal-title":"Arch Esp Urol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib5","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1097\/00000658-199505000-00013","article-title":"Determinants of mortality for necrotizing soft-tissue infections","volume":"221","author":"McHenry","year":"1995","journal-title":"Ann Surg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib6","first-page":"85","article-title":"Evaluation of factors affecting mortality in Fournier's Gangrene: retrospective clinical study of sixteen cases","volume":"30","author":"Oymaci","year":"2014","journal-title":"Ulus Cerrahi Derg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib7","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/S0002-9610(00)00360-3","article-title":"The microbiology of necrotizing soft tissue infections","volume":"179","author":"Elliott","year":"2000","journal-title":"Am J Surg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib8","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1186\/s12879-018-3355-7","article-title":"Signs, symptoms and diagnosis of necrotizing fasciitis experienced by survivors and family: a qualitative Nordic multi-center study","volume":"18","author":"Erichsen Andersson","year":"2018","journal-title":"BMC Infect Dis"},{"key":"10.1016\/j.jemermed.2019.06.023_bib9","doi-asserted-by":"crossref","first-page":"157","DOI":"10.4081\/aiua.2016.3.157","article-title":"A clinical review","volume":"88","author":"Singh","year":"2016","journal-title":"Arch Ital Urol Androl"},{"key":"10.1016\/j.jemermed.2019.06.023_bib10","doi-asserted-by":"crossref","first-page":"2120","DOI":"10.1016\/j.juro.2009.01.034","article-title":"Fournier's Gangrene: population based epidemiology and outcomes","volume":"181","author":"Sorensen","year":"2009","journal-title":"J Urol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib11","first-page":"16","article-title":"Fournier's gangrene -- analysis of management and outcome in south-eastern Nigeria","volume":"50","author":"Ugwumba","year":"2012","journal-title":"S Afr J Surg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib12","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1159\/000445695","article-title":"Fournier's Gangrene: Epidemiology and Outcomes in the General US Population","volume":"97","author":"Sorensen","year":"2016","journal-title":"Urol Int"},{"key":"10.1016\/j.jemermed.2019.06.023_bib13","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1159\/000342407","article-title":"Epidemiological characteristics of Fournier's gangrene: a report of 71 patients","volume":"89","author":"Aridogan","year":"2012","journal-title":"Urol Int"},{"key":"10.1016\/j.jemermed.2019.06.023_bib14","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1159\/000339161","article-title":"Prognostic aspects, survival rate, and predisposing risk factors in patients with Fournier's gangrene and necrotizing soft tissue infections: evaluation of clinical outcome of 55 patients","volume":"89","author":"Martinschek","year":"2012","journal-title":"Urol Int"},{"key":"10.1016\/j.jemermed.2019.06.023_bib15","doi-asserted-by":"crossref","first-page":"942437","DOI":"10.5402\/2012\/942437","article-title":"Fournier's gangrene: current practices","volume":"2012","author":"Mallikarjuna","year":"2012","journal-title":"ISRN Surg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib16","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1038\/sc.2011.75","article-title":"Pressure sores significantly increase the risk of developing a Fournier's gangrene in patients with spinal cord injury","volume":"49","author":"Backhaus","year":"2011","journal-title":"Spinal Cord"},{"key":"10.1016\/j.jemermed.2019.06.023_bib17","first-page":"617","article-title":"The spectrum of presentation and management of Fournier's gangrene--an experience of 73 cases","volume":"60","author":"Malik","year":"2010","journal-title":"J Pak Med Assoc"},{"key":"10.1016\/j.jemermed.2019.06.023_bib18","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1016\/S0039-6109(02)00058-0","article-title":"Fournier's gangrene","volume":"82","author":"Morpurgo","year":"2002","journal-title":"Surg Clin North Am"},{"key":"10.1016\/j.jemermed.2019.06.023_bib19","first-page":"49","article-title":"Causes, presentation and survival of fifty-seven patients with necrotizing fasciitis of the male genitalia","volume":"170","author":"Clayton","year":"1990","journal-title":"Surg Gynecol Obstet"},{"key":"10.1016\/j.jemermed.2019.06.023_bib20","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1111\/j.1445-2197.2005.03609.x","article-title":"Fournier's gangrene: a retrospective clinical study on forty-one patients","volume":"75","author":"Ayan","year":"2005","journal-title":"ANZ J Surg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib21","first-page":"283","article-title":"Impact of immunodeficiency virus (HIV) on Fournier's gangrene: observations in Zambia","volume":"77","author":"Elem","year":"1995","journal-title":"Ann R Coll Surg Engl"},{"key":"10.1016\/j.jemermed.2019.06.023_bib22","doi-asserted-by":"crossref","first-page":"36","DOI":"10.3389\/fsurg.2014.00036","article-title":"Current concepts in the management of necrotizing fasciitis","volume":"1","author":"Misiakos","year":"2014","journal-title":"Front Surg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib23","first-page":"1662","article-title":"Necrotising soft tissue infection-risk factors for mortality","volume":"7","author":"Kalaivani","year":"2013","journal-title":"J Clin Diagn Res"},{"key":"10.1016\/j.jemermed.2019.06.023_bib24","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1136\/pgmj.2005.042069","article-title":"Fournier's gangrene and its emergency management","volume":"82","author":"Thwaini","year":"2006","journal-title":"Postgrad Med J"},{"key":"10.1016\/j.jemermed.2019.06.023_bib25","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1007\/s11255-005-2946-6","article-title":"Fournier's gangrene: exists and it is still lethal","volume":"38","author":"Safioleas","year":"2006","journal-title":"Int Urol Nephrol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib26","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1046\/j.1464-410x.1999.00140.x","article-title":"Fournier's gangrene in a modern surgical setting: improved survival with aggressive management","volume":"84","author":"Corman","year":"1999","journal-title":"BJU Int"},{"key":"10.1016\/j.jemermed.2019.06.023_bib27","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1177\/1756287215584740","article-title":"Contemporary diagnosis and management of Fournier's gangrene","volume":"7","author":"Chennamsetty","year":"2015","journal-title":"Ther Adv Urol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib28","first-page":"136","article-title":"Perineal progressive myonecrosis following Thiersch's operation for rectal prolapse","volume":"76","author":"Rye","year":"1987","journal-title":"Ann Chir Gynaecol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib29","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1007\/s11255-006-9126-1","article-title":"Bilateral testicular gangrene: does it occur in Fournier's gangrene?","volume":"39","author":"Gupta","year":"2007","journal-title":"Int Urol Nephrol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib30","doi-asserted-by":"crossref","first-page":"331","DOI":"10.5173\/ceju.2013.03.art22","article-title":"A three-year review of the management of Fournier's gangrene presented in a single Saudi Arabian institute","volume":"66","author":"Katib","year":"2013","journal-title":"Cent European J Urol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib31","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/S0302-2838(03)00102-7","article-title":"Fournier's gangrene: an analysis of repeated surgical debridement","volume":"43","author":"Chawla","year":"2003","journal-title":"Eur Urol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib32","first-page":"423","article-title":"Synchronous caverno-spongious thrombosis and Fournier's gangrene","volume":"43","author":"Campos","year":"1990","journal-title":"Arch Esp Urol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib33","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1046\/j.1464-410x.1998.00532.x","article-title":"Fournier's gangrene","volume":"81","author":"Smith","year":"1998","journal-title":"Br J Urol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib34","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1016\/S0094-0143(05)70224-X","article-title":"Fournier's disease","volume":"26","author":"Vick","year":"1999","journal-title":"Urol Clin North Am"},{"key":"10.1016\/j.jemermed.2019.06.023_bib35","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1007\/s10140-005-0417-0","article-title":"CT findings of perforated rectal carcinoma presenting as Fournier's gangrene in the emergency department","volume":"11","author":"Ash","year":"2005","journal-title":"Emerg Radiol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib36","doi-asserted-by":"crossref","first-page":"43","DOI":"10.9738\/CC168.1","article-title":"Fournier gangrene as a manifestation of undiagnosed metastatic perforated colorectal cancer","volume":"98","author":"Chan","year":"2013","journal-title":"Int Surg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib37","doi-asserted-by":"crossref","first-page":"e424","DOI":"10.1016\/j.ijid.2009.01.021","article-title":"The evaluation of microbiology and Fournier's gangrene severity index in 27 patients","volume":"13","author":"Ulug","year":"2009","journal-title":"Int J Infect Dis"},{"key":"10.1016\/j.jemermed.2019.06.023_bib38","doi-asserted-by":"crossref","first-page":"267","DOI":"10.33073\/pjm-2014-036","article-title":"Fournier's gangrene--current concepts","volume":"63","author":"Wroblewska","year":"2014","journal-title":"Pol J Microbiol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib39","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1080\/00365540410017086","article-title":"Fournier's gangrene after genital piercing","volume":"36","author":"Ekelius","year":"2004","journal-title":"Scand J Infect Dis"},{"key":"10.1016\/j.jemermed.2019.06.023_bib40","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1007\/BF00206944","article-title":"Fournier's gangrene: CT findings","volume":"19","author":"Amendola","year":"1994","journal-title":"Abdom Imaging"},{"key":"10.1016\/j.jemermed.2019.06.023_bib41","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s40064-014-0783-8","article-title":"The evaluation of microbiology and prognosis of fournier's gangrene in past five years","volume":"4","author":"Tang","year":"2015","journal-title":"Springerplus"},{"key":"10.1016\/j.jemermed.2019.06.023_bib42","first-page":"473","article-title":"Necrotizing fasciitis of vulvar origin in diabetic patients","volume":"63","author":"Addison","year":"1984","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib43","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/S0094-0143(21)00855-7","article-title":"Gangrene and Fournier's gangrene","volume":"19","author":"Paty","year":"1992","journal-title":"Urol Clin North Am"},{"key":"10.1016\/j.jemermed.2019.06.023_bib44","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1007\/s00268-005-0777-3","article-title":"Fournier's gangrene: risk factors and strategies for management","volume":"30","author":"Yanar","year":"2006","journal-title":"World J Surg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib45","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1089\/sur.2013.118","article-title":"Emergence of antibiotic-resistant bacteria in patients with Fournier gangrene","volume":"16","author":"Lin","year":"2015","journal-title":"Surg Infect (Larchmt)"},{"key":"10.1016\/j.jemermed.2019.06.023_bib46","first-page":"1","article-title":"Fungal Fourniers gangrene in an immunocompromised patient","volume":"4","author":"Crowell","year":"2016","journal-title":"Urol Case Rep"},{"key":"10.1016\/j.jemermed.2019.06.023_bib47","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S0090-4295(00)00527-6","article-title":"Fournier's gangrene caused by Candida species as the primary organism","volume":"56","author":"Johnin","year":"2000","journal-title":"Urology"},{"key":"10.1016\/j.jemermed.2019.06.023_bib48","first-page":"707","article-title":"[Fournier's gangrene caused by Candida albicans]","volume":"42","author":"Temiz","year":"2008","journal-title":"Mikrobiyol Bul"},{"key":"10.1016\/j.jemermed.2019.06.023_bib49","doi-asserted-by":"crossref","first-page":"431","DOI":"10.2340\/00015555-0847","article-title":"Necrotizing soft tissue infection of the glans penis due to atypical Candida species complicated with Fournier's gangrene","volume":"90","author":"Jensen","year":"2010","journal-title":"Acta Derm Venereol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib50","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1080\/00365540410015916","article-title":"Lactobacillus gasseri causing Fournier's gangrene","volume":"36","author":"Tleyjeh","year":"2004","journal-title":"Scand J Infect Dis"},{"key":"10.1016\/j.jemermed.2019.06.023_bib51","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.surge.2013.02.001","article-title":"Fournier's gangrene","volume":"11","author":"Shyam","year":"2013","journal-title":"Surgeon"},{"key":"10.1016\/j.jemermed.2019.06.023_bib52","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1038\/modpathol.3800639","article-title":"Zygomycotic necrotizing fasciitis in immunocompetent patients: a series of 18 cases","volume":"19","author":"Jain","year":"2006","journal-title":"Mod Pathol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib53","doi-asserted-by":"crossref","first-page":"e119","DOI":"10.1002\/bjs.9371","article-title":"Early diagnosis of necrotizing fasciitis","volume":"101","author":"Goh","year":"2014","journal-title":"Br J Surg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib54","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.2106\/00004623-200308000-00005","article-title":"Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality","volume":"85-A","author":"Wong","year":"2003","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.jemermed.2019.06.023_bib55","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1097\/00000658-198711000-00018","article-title":"Improved results from a standardized approach in treating patients with necrotizing fasciitis","volume":"206","author":"Sudarsky","year":"1987","journal-title":"Ann Surg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib56","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1111\/j.1445-2197.2006.03975.x","article-title":"Factors affecting mortality of Fournier's gangrene: review of 70 patients","volume":"77","author":"Ersay","year":"2007","journal-title":"ANZ J Surg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib57","first-page":"294","article-title":"[Fournier's gangrene: anatomo-clinical features in adults and children. Therapy update]","volume":"24","author":"Rodriguez Alonso","year":"2000","journal-title":"Actas Urol Esp"},{"key":"10.1016\/j.jemermed.2019.06.023_bib58","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1097\/01.prs.0000244925.80290.57","article-title":"Fournier's gangrene: a review of 43 reconstructive cases","volume":"119","author":"Ferreira","year":"2007","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib59","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1097\/SLA.0000000000002774","article-title":"Necrotizing soft tissue infection: diagnostic accuracy of physical examination, imaging, and LRINEC score: a systematic review and meta-analysis","volume":"269","author":"Fernando","year":"2019","journal-title":"Ann Surg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib60","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/S0039-6109(16)46331-0","article-title":"Necrotizing soft-tissue infections","volume":"74","author":"Sutherland","year":"1994","journal-title":"Surg Clin North Am"},{"key":"10.1016\/j.jemermed.2019.06.023_bib61","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1159\/000247930","article-title":"Extremely extended Fournier's gangrene","volume":"181","author":"Saijo","year":"1990","journal-title":"Dermatologica"},{"key":"10.1016\/j.jemermed.2019.06.023_bib62","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/S0090-4295(00)00604-X","article-title":"Outcome analysis in patients with primary necrotizing fasciitis of the male genitalia","volume":"56","author":"Dahm","year":"2000","journal-title":"Urology"},{"key":"10.1016\/j.jemermed.2019.06.023_bib63","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1016\/S0210-4806(09)72884-0","article-title":"[Fournier's gangrene: from urological emergency to plastic surgery]","volume":"33","author":"Horta","year":"2009","journal-title":"Actas Urol Esp"},{"key":"10.1016\/j.jemermed.2019.06.023_bib64","doi-asserted-by":"crossref","first-page":"e4274","DOI":"10.1136\/bmj.e4274","article-title":"Necrotising fasciitis","volume":"345","author":"Sultan","year":"2012","journal-title":"BMJ"},{"key":"10.1016\/j.jemermed.2019.06.023_bib65","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1097\/01.CCM.0000129486.35458.7D","article-title":"The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections","volume":"32","author":"Wong","year":"2004","journal-title":"Crit Care Med"},{"key":"10.1016\/j.jemermed.2019.06.023_bib66","doi-asserted-by":"crossref","first-page":"333","DOI":"10.5811\/westjem.2016.2.29069","article-title":"Inadequate sensitivity of laboratory risk indicator to rule out necrotizing fasciitis in the emergency department","volume":"17","author":"Burner","year":"2016","journal-title":"West J Emerg Med"},{"key":"10.1016\/j.jemermed.2019.06.023_bib67","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/j.bjps.2014.11.003","article-title":"Analysis of the increasing prevalence of necrotising fasciitis referrals to a regional plastic surgery unit: a retrospective case series","volume":"68","author":"Hodgins","year":"2015","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib68","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1308\/003588413X13511609956093","article-title":"A five-year review of necrotising fasciitis in a tertiary referral unit","volume":"95","author":"Swain","year":"2013","journal-title":"Ann R Coll Surg Engl"},{"key":"10.1016\/j.jemermed.2019.06.023_bib69","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1016\/j.jemermed.2012.09.039","article-title":"A case of necrotizing fasciitis with a LRINEC score of zero: clinical suspicion should trump scoring systems","volume":"44","author":"Wilson","year":"2013","journal-title":"J Emerg Med"},{"key":"10.1016\/j.jemermed.2019.06.023_bib70","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.urology.2004.03.049","article-title":"Fournier's gangrene: experience with 25 patients and use of Fournier's gangrene severity index score","volume":"64","author":"Yeniyol","year":"2004","journal-title":"Urology"},{"key":"10.1016\/j.jemermed.2019.06.023_bib71","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1111\/j.1442-2042.2005.01204.x","article-title":"Prognostic factors in Fournier gangrene","volume":"12","author":"Jeong","year":"2005","journal-title":"Int J Urol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib72","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1016\/j.eururo.2006.01.030","article-title":"Fournier's gangrene: three years of experience with 20 patients and validity of the Fournier's Gangrene Severity Index Score","volume":"50","author":"Tuncel","year":"2006","journal-title":"Eur Urol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib73","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1159\/000335507","article-title":"Fournier's gangrene: etiology and outcome analysis of 41 patients","volume":"88","author":"Altarac","year":"2012","journal-title":"Urol Int"},{"key":"10.1016\/j.jemermed.2019.06.023_bib74","doi-asserted-by":"crossref","first-page":"161","DOI":"10.4103\/0970-1591.117255","article-title":"Prospective evaluation of risk factors for mortality in patients of Fournier's gangrene: a single center experience","volume":"29","author":"Vyas","year":"2013","journal-title":"Indian J Urol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib75","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1007\/s11255-008-9401-4","article-title":"The clinical features of Fournier's gangrene and the predictivity of the Fournier's Gangrene Severity Index on the outcomes","volume":"40","author":"Kabay","year":"2008","journal-title":"Int Urol Nephrol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib76","doi-asserted-by":"crossref","first-page":"102","DOI":"10.4103\/0022-3859.40775","article-title":"Fournier's gangrene: evaluation of 68 patients and analysis of prognostic variables","volume":"54","author":"Unalp","year":"2008","journal-title":"J Postgrad Med"},{"key":"10.1016\/j.jemermed.2019.06.023_bib77","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1080\/00015458.2009.11680404","article-title":"Evaluation of risk factors and severity of a life threatening surgical emergency: Fournier's gangrene (a report of 15 cases)","volume":"109","author":"Kara","year":"2009","journal-title":"Acta Chir Belg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib78","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/S0022-5347(01)67236-7","article-title":"Outcome prediction in patients with Fournier's gangrene","volume":"154","author":"Laor","year":"1995","journal-title":"J Urol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib79","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1086\/511638","article-title":"Necrotizing soft-tissue infection: diagnosis and management","volume":"44","author":"Anaya","year":"2007","journal-title":"Clin Infect Dis"},{"key":"10.1016\/j.jemermed.2019.06.023_bib80","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1148\/radiology.203.3.9169717","article-title":"Necrotizing fasciitis: CT characteristics","volume":"203","author":"Wysoki","year":"1997","journal-title":"Radiology"},{"key":"10.1016\/j.jemermed.2019.06.023_bib81","doi-asserted-by":"crossref","first-page":"104","DOI":"10.4103\/2229-5151.97276","article-title":"Ultrasound in the diagnosis of Fournier's gangrene","volume":"2","author":"Kube","year":"2012","journal-title":"Int J Crit Illn Inj Sci"},{"key":"10.1016\/j.jemermed.2019.06.023_bib82","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/S0090-4295(96)00103-3","article-title":"Ultrasonographic appearance of necrotizing gangrene: aid in early diagnosis","volume":"48","author":"Kane","year":"1996","journal-title":"Urology"},{"key":"10.1016\/j.jemermed.2019.06.023_bib83","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1148\/rg.282075048","article-title":"Fournier gangrene: role of imaging","volume":"28","author":"Levenson","year":"2008","journal-title":"Radiographics"},{"key":"10.1016\/j.jemermed.2019.06.023_bib84","first-page":"1448","article-title":"Ultrasonographic screening of clinically-suspected necrotizing fasciitis","volume":"9","author":"Yen","year":"2002","journal-title":"Acad Emerg Med"},{"key":"10.1016\/j.jemermed.2019.06.023_bib85","doi-asserted-by":"crossref","first-page":"111","DOI":"10.5811\/westjem.2013.8.18303","article-title":"Diagnosis of necrotizing faciitis with bedside ultrasound: the STAFF Exam","volume":"15","author":"Castleberg","year":"2014","journal-title":"West J Emerg Med"},{"key":"10.1016\/j.jemermed.2019.06.023_bib86","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.jemermed.2013.11.087","article-title":"Point-of-care ultrasound diagnosis of necrotizing fasciitis missed by computed tomography and magnetic resonance imaging","volume":"47","author":"Kehrl","year":"2014","journal-title":"J Emerg Med"},{"key":"10.1016\/j.jemermed.2019.06.023_bib87","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1007\/s00268-017-4145-x","article-title":"The role of computed tomography in the diagnosis of necrotizing soft tissue infections","volume":"42","author":"Martinez","year":"2018","journal-title":"World J Surg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib88","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1001\/archsurg.2010.50","article-title":"Diagnosis of necrotizing soft tissue infections by computed tomography","volume":"145","author":"Zacharias","year":"2010","journal-title":"Arch Surg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib89","doi-asserted-by":"crossref","first-page":"163","DOI":"10.2214\/ajr.170.1.9423625","article-title":"Radiology of Fournier's gangrene","volume":"170","author":"Rajan","year":"1998","journal-title":"AJR Am J Roentgenol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib90","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1007\/s00261-006-9035-x","article-title":"Fournier's gangrene: a radiologic emergency","volume":"31","author":"Piedra","year":"2006","journal-title":"Abdom Imaging"},{"key":"10.1016\/j.jemermed.2019.06.023_bib91","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1148\/radiol.11101164","article-title":"Can necrotizing infectious fasciitis be differentiated from nonnecrotizing infectious fasciitis with MR imaging?","volume":"259","author":"Kim","year":"2011","journal-title":"Radiology"},{"key":"10.1016\/j.jemermed.2019.06.023_bib92","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.jbspin.2012.08.009","article-title":"Necrotizing fasciitis: contribution and limitations of diagnostic imaging","volume":"80","author":"Malghem","year":"2013","journal-title":"Joint Bone Spine"},{"key":"10.1016\/j.jemermed.2019.06.023_bib93","doi-asserted-by":"crossref","first-page":"989","DOI":"10.2214\/ajr.154.5.2138843","article-title":"MR imaging of thoracic and abdominal wall infections: comparison with other imaging procedures","volume":"154","author":"Sharif","year":"1990","journal-title":"AJR Am J Roentgenol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib94","first-page":"76","article-title":"MRI can determine the adequate area for debridement in the case of Fournier's gangrene","volume":"95","author":"Yoneda","year":"2010","journal-title":"Int Surg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib95","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1111\/j.1742-4801.2004.00054.x","article-title":"Necrotising fasciitis: a new management algorithm based on clinical classification","volume":"1","author":"Carter","year":"2004","journal-title":"Int Wound J"},{"key":"10.1016\/j.jemermed.2019.06.023_bib96","doi-asserted-by":"crossref","first-page":"e10","DOI":"10.1093\/cid\/ciu296","article-title":"Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America","volume":"59","author":"Stevens","year":"2014","journal-title":"Clin Infect Dis"},{"key":"10.1016\/j.jemermed.2019.06.023_bib97","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.jhin.2010.01.028","article-title":"Diagnosis and management of necrotising fasciitis: a multiparametric approach","volume":"75","author":"Morgan","year":"2010","journal-title":"J Hosp Infect"},{"key":"10.1016\/j.jemermed.2019.06.023_bib98","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.riam.2014.06.005","article-title":"Fungal necrotizing fasciitis, an emerging infectious disease caused by Apophysomyces (Mucorales)","volume":"32","author":"Chander","year":"2015","journal-title":"Rev Iberoam Micol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib99","first-page":"E18","article-title":"Fungal necrotizing fasciitis of the head and neck in 3 patients with uncontrolled diabetes","volume":"93","author":"Prasanna Kumar","year":"2014","journal-title":"Ear Nose Throat J"},{"key":"10.1016\/j.jemermed.2019.06.023_bib100","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1080\/00365540410020866","article-title":"Successful management of severe group A streptococcal soft tissue infections using an aggressive medical regimen including intravenous polyspecific immunoglobulin together with a conservative surgical approach","volume":"37","author":"Norrby-Teglund","year":"2005","journal-title":"Scand J Infect Dis"},{"key":"10.1016\/j.jemermed.2019.06.023_bib101","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1086\/515199","article-title":"Intravenous immunoglobulin therapy for streptococcal toxic shock syndrome--a comparative observational study. The Canadian Streptococcal Study Group","volume":"28","author":"Kaul","year":"1999","journal-title":"Clin Infect Dis"},{"key":"10.1016\/j.jemermed.2019.06.023_bib102","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.1007\/s00134-017-4786-0","article-title":"Immunoglobulin G for patients with necrotising soft tissue infection (INSTINCT): a randomised, blinded, placebo-controlled trial","volume":"43","author":"Madsen","year":"2017","journal-title":"Intensive Care Med"},{"key":"10.1016\/j.jemermed.2019.06.023_bib103","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1111\/trf.14067","article-title":"Outcomes in necrotizing soft tissue infections treated with therapeutic plasma exchange","volume":"57","author":"Saifee","year":"2017","journal-title":"Transfusion"},{"key":"10.1016\/j.jemermed.2019.06.023_bib104","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/1749-7922-8-13","article-title":"Fournier's gangrene: our experience with 50 patients and analysis of factors affecting mortality","volume":"8","author":"Benjelloun el","year":"2013","journal-title":"World J Emerg Surg"},{"key":"10.1016\/j.jemermed.2019.06.023_bib105","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1007\/s00134-017-4683-6","article-title":"Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock: 2016","volume":"43","author":"Rhodes","year":"2017","journal-title":"Intensive Care Med"},{"key":"10.1016\/j.jemermed.2019.06.023_bib106","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1056\/NEJMoa1711584","article-title":"Balanced crystalloids versus saline in critically ill adults","volume":"378","author":"Semler","year":"2018","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jemermed.2019.06.023_bib107","doi-asserted-by":"crossref","first-page":"1935","DOI":"10.1007\/s00134-015-4134-1","article-title":"Passive leg raising for predicting fluid responsiveness: a systematic review and meta-analysis","volume":"42","author":"Monnet","year":"2016","journal-title":"Intensive Care Med"},{"key":"10.1016\/j.jemermed.2019.06.023_bib108","doi-asserted-by":"crossref","first-page":"1298","DOI":"10.1001\/jama.2016.12310","article-title":"Will this hemodynamically unstable patient respond to a bolus of intravenous fluids?","volume":"316","author":"Bentzer","year":"2016","journal-title":"JAMA"},{"key":"10.1016\/j.jemermed.2019.06.023_bib109","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1186\/s13054-014-0532-y","article-title":"Early versus delayed administration of norepinephrine in patients with septic shock","volume":"18","author":"Bai","year":"2014","journal-title":"Crit Care"},{"key":"10.1016\/j.jemermed.2019.06.023_bib110","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1089\/sur.2017.255","article-title":"Vasopressors in sepsis","volume":"19","author":"Colling","year":"2018","journal-title":"Surg Infect (Larchmt)"},{"key":"10.1016\/j.jemermed.2019.06.023_bib111","doi-asserted-by":"crossref","first-page":"260","DOI":"10.7326\/0003-4819-154-4-201102150-00007","article-title":"Clinical Guidelines Committee of the American College of P. Use of intensive insulin therapy for the management of glycemic control in hospitalized patients: a clinical practice guideline from the American College of Physicians","volume":"154","author":"Qaseem","year":"2011","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.jemermed.2019.06.023_bib112","doi-asserted-by":"crossref","first-page":"255","DOI":"10.2147\/DMSO.S50516","article-title":"Management of adult diabetic ketoacidosis","volume":"7","author":"Gosmanov","year":"2014","journal-title":"Diabetes Metab Syndr Obes"},{"issue":"9 suppl","key":"10.1016\/j.jemermed.2019.06.023_bib113","doi-asserted-by":"crossref","first-page":"S494","DOI":"10.1097\/CCM.0b013e3181ec5412","article-title":"Alcohol withdrawal syndromes in the intensive care unit","volume":"38","author":"Sarff","year":"2010","journal-title":"Crit Care Med"},{"key":"10.1016\/j.jemermed.2019.06.023_bib114","doi-asserted-by":"crossref","first-page":"619","DOI":"10.20344\/amp.6300","article-title":"Hyperbaric oxygen therapy for the treatment of Fournier's gangrene: a review of 34 cases","volume":"28","author":"Rosa","year":"2015","journal-title":"Acta Med Port"},{"key":"10.1016\/j.jemermed.2019.06.023_bib115","doi-asserted-by":"crossref","first-page":"1975","DOI":"10.1097\/01.ju.0000158129.56571.05","article-title":"Hyperbaric oxygen for the treatment of fournier's gangrene","volume":"173","author":"Mindrup","year":"2005","journal-title":"J Urol"},{"key":"10.1016\/j.jemermed.2019.06.023_bib116","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/j.surg.2011.06.005","article-title":"Transfer status: a risk factor for mortality in patients with necrotizing fasciitis","volume":"150","author":"Holena","year":"2011","journal-title":"Surgery"},{"key":"10.1016\/j.jemermed.2019.06.023_bib117","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.jss.2017.06.006","article-title":"Effect of transfer status on outcomes for necrotizing soft tissue infections","volume":"220","author":"Ingraham","year":"2017","journal-title":"J Surg Res"}],"container-title":["The Journal of Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0736467919304846?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0736467919304846?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:43:50Z","timestamp":1760028230000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0736467919304846"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10]]},"references-count":117,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,10]]}},"alternative-id":["S0736467919304846"],"URL":"https:\/\/doi.org\/10.1016\/j.jemermed.2019.06.023","relation":{},"ISSN":["0736-4679"],"issn-type":[{"value":"0736-4679","type":"print"}],"subject":[],"published":{"date-parts":[[2019,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Fournier Gangrene: A Review for Emergency Clinicians","name":"articletitle","label":"Article Title"},{"value":"The Journal of Emergency Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jemermed.2019.06.023","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}