{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T14:48:21Z","timestamp":1780757301879,"version":"3.54.1"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T00:00:00Z","timestamp":1605052800000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Necrotizing fasciitis is an aggressive, life threatening soft tissue infection that requires high index of suspicion for diagnosis. Diagnosis is clinical with management including broad spectrum antibiotics and emergent operative debridement. The majority of cases are secondary to underlying medical processes, local tissue damage, abscess, or inciting procedure, with a paucity of data correlating causation with colon cancer. We describe the case of an 84-year-old man presenting with sepsis of unknown origin who was diagnosed with an atypical presentation of necrotizing fasciitis secondary to a perforated cecal malignancy. His case is unique in that a less virulent polymicrobial infection was likely involved as he initially improved with conservative management alone. He ultimately declined and expired secondary to overwhelming sepsis from his infection. This case highlights the importance of maintaining a high index of suspicion for necrotizing infection and considerations for alternative etiologies of infection including perforated malignancies.<\/jats:p>","DOI":"10.1093\/jscr\/rjaa371","type":"journal-article","created":{"date-parts":[[2020,8,17]],"date-time":"2020-08-17T19:14:51Z","timestamp":1597691691000},"source":"Crossref","is-referenced-by-count":13,"title":["An atypical case of necrotizing fasciitis secondary to perforated cecal cancer"],"prefix":"10.1093","volume":"2020","author":[{"given":"Laura S","family":"Heidelberg","sequence":"first","affiliation":[{"name":"Swedish Colon and Rectal Clinic, Swedish Medical Center, Seattle, WA 98104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica N","family":"Pettke","sequence":"additional","affiliation":[{"name":"Swedish Colon and Rectal Clinic, Swedish Medical Center, Seattle, WA 98104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Swedish Medical Group, Seattle, WA 98104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Angotti","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Swedish Medical Group, Seattle, WA 98104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,11,10]]},"reference":[{"key":"2020120620362460600_ref1","volume-title":"Necrotizing soft tissue infections","author":"Stevens","year":"2020"},{"key":"2020120620362460600_ref2","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 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ascending colon cancer: a case report","volume":"10","author":"Harada","year":"2017","journal-title":"ID Cases"},{"key":"2020120620362460600_ref7","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.annfar.2005.01.013","article-title":"Necrotizing bacterial skin and soft tissue infection with muscular involvement revealing cancer of the colon","volume":"24","author":"Crousier","year":"2005","journal-title":"Ann Fr Anesth Reanim"},{"key":"2020120620362460600_ref8","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/1471-2482-6-11","article-title":"Perforated carcinoma of the caecum presenting as necrotising faciitis of the abdominal wall, the key to early diagnosis and management","volume":"6","author":"Marron","year":"2006","journal-title":"BMC Surg"},{"key":"2020120620362460600_ref9","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"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jscr\/article-pdf\/2020\/11\/rjaa371\/34284716\/rjaa371.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jscr\/article-pdf\/2020\/11\/rjaa371\/34284716\/rjaa371.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,7]],"date-time":"2020-12-07T03:40:18Z","timestamp":1607312418000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjaa371\/5964200"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,1]]},"references-count":9,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2020,11,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjaa371","relation":{},"ISSN":["2042-8812"],"issn-type":[{"value":"2042-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,11]]},"published":{"date-parts":[[2020,11,1]]},"article-number":"rjaa371"}}