{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T09:18:23Z","timestamp":1696065503824},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Severe group A streptococcus (GAS) infections, particularly necrotizing soft tissue infections (NSTIs), have been associated with the development of streptococcal toxic-shock syndrome (STSS), a systemic illness caused by GAS-derived toxins. Traditional physical examination findings in NSTIs include skin necrosis, crepitus, and hemorrhagic bullae. However, these findings are limited in sensitivity and additional clinical markers may aid in making an early diagnosis of NSTI. We present a case of a superficial infection, specifically GAS necrotizing cellulitis, complicated by STSS in a healthy boy with an associated skin finding of retiform purpura that aided in early diagnosis of a NSTI.<\/jats:p>","DOI":"10.1097\/pec.0000000000002251","type":"journal-article","created":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T17:38:19Z","timestamp":1600882699000},"page":"e646-e648","source":"Crossref","is-referenced-by-count":1,"title":["Retiform Purpura as a Sign of Necrotizing Cellulitis in an Immunocompetent Boy"],"prefix":"10.1097","volume":"36","author":[{"given":"Nader","family":"Aboul-Fettouh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khang D.","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arturo R.","family":"Dominguez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2020,9,23]]},"reference":[{"key":"bib1-20230930","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","year":"2004","journal-title":"Crit Care Med"},{"key":"bib2-20230930","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1016\/j.jpedsurg.2016.02.076","article-title":"Laboratory evaluation for pediatric patients with suspected necrotizing soft tissue infections: a case-control study","volume":"51","year":"2016","journal-title":"J Pediatr Surg"},{"key":"bib3-20230930","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","year":"2014","journal-title":"Curr Probl Surg"},{"key":"bib4-20230930","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1001\/jama.2016.8825","article-title":"Cellulitis: a review","volume":"316","year":"2016","journal-title":"JAMA"},{"key":"bib5-20230930","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1093\/cid\/ciw248","article-title":"Epidemiology of invasive group A streptococcal infections in the United States, 2005\u20132012","volume":"63","year":"2016","journal-title":"Clin Infect Dis"},{"key":"bib6-20230930","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1001\/jama.1993.03500030088038","article-title":"Defining the group A streptococcal toxic shock syndrome. 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