{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T23:15:42Z","timestamp":1792710942803,"version":"4.5.0"},"reference-count":12,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,4,8]]},"abstract":"<jats:p>Necrotising fasciitis is a rapidly progressive soft\u00a0tissue infection that leads to diffuse tissue necrosis. It is associated with systemic toxicity and rapid deterioration resulting in high mortality. Rapid diagnosis and prompt treatment are essential to improve the outcome. We report the case of a 26-year-old woman who presented with severe thigh pain and swelling associated with irritability of a few hours\u2019 duration following 2\u2005days history of right abdominal pain. Urgent MRI and CT scan showed features of necrotising fasciitis in the thigh spreading from an inflamed appendix. Emergency surgery was performed which revealed perforated appendix with disseminated infection in the intraperitoneal and retroperitoneal spaces as well as the right thigh. The patient rapidly deteriorated with evidence of sepsis, shock and renal impairment. In spite of surgery and all supportive measures, she succumbed shortly postoperatively. Blood culture revealed<jats:italic>Staphylococcus aureus<\/jats:italic>and<jats:italic>Streptococci<\/jats:italic>, while tissue culture showed growth of<jats:italic>Escherichia coli<\/jats:italic>and proteus.<\/jats:p>","DOI":"10.1136\/bcr-2014-204247","type":"journal-article","created":{"date-parts":[[2014,5,2]],"date-time":"2014-05-02T13:57:46Z","timestamp":1399039066000},"page":"bcr2014204247","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Missed acute appendicitis presenting as necrotising fasciitis of the thigh"],"prefix":"10.1136","volume":"2014","author":[{"given":"Sawsan","family":"Taif","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asif","family":"Alrawi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2014,5,2]]},"reference":[{"key":"2025042703314570000_2014.apr30_3.bcr2014204247.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2007.09.026"},{"key":"2025042703314570000_2014.apr30_3.bcr2014204247.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-6757(99)90205-X"},{"key":"2025042703314570000_2014.apr30_3.bcr2014204247.3","first-page":"139","article-title":"A successfully treated case of severe necrotizing fasciitis caused by acute appendicitis: a case report","volume":"28","author":"Mukoyama","year":"2003","journal-title":"Tokai J Exp Clin Med"},{"key":"2025042703314570000_2014.apr30_3.bcr2014204247.4","first-page":"380","article-title":"Femoral appendicitis: an unusual case","volume":"32","author":"Guirguis","year":"1989","journal-title":"Can J Surg"},{"key":"2025042703314570000_2014.apr30_3.bcr2014204247.5","first-page":"307","article-title":"Necrotising fasciitis of the lower limb caused by undiagnosed perforated appendicitis, which necessitated disarticulation of the hip","volume":"159","author":"Jacobs","year":"1993","journal-title":"Eur J Surg"},{"key":"2025042703314570000_2014.apr30_3.bcr2014204247.6","doi-asserted-by":"publisher","DOI":"10.1080\/00016340600613816"},{"key":"2025042703314570000_2014.apr30_3.bcr2014204247.7","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000129486.35458.7D"},{"key":"2025042703314570000_2014.apr30_3.bcr2014204247.8","doi-asserted-by":"crossref","first-page":"196","DOI":"10.3928\/01477447-20110124-20","article-title":"Diagnosis and management of necrotizing fasciitis","volume":"34","author":"Stoneback","year":"2011","journal-title":"Orthopedics"},{"key":"2025042703314570000_2014.apr30_3.bcr2014204247.9","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.09.7156"},{"key":"2025042703314570000_2014.apr30_3.bcr2014204247.10","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20130560"},{"key":"2025042703314570000_2014.apr30_3.bcr2014204247.11","doi-asserted-by":"publisher","DOI":"10.1148\/rg.245035169"},{"key":"2025042703314570000_2014.apr30_3.bcr2014204247.12","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.11101164"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2014-204247","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T10:31:56Z","timestamp":1745749916000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2014-204247"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,5,2]]},"references-count":12,"alternative-id":["10.1136\/bcr-2014-204247"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2014-204247","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,5,2]]}}}