{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T09:42:37Z","timestamp":1756460557190,"version":"3.44.0"},"reference-count":16,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,12,19]]},"abstract":"<jats:p>A 24-year-old woman who was 24 weeks pregnant presented to the emergency department with septic shock and an elbow wound that had become infected. She sustained an injury to the tip of the right elbow on a light switch 4 days prior. In the space of 1\u2009day, she developed a necrotising soft tissue infection, which was rapidly spread to the forearm with florid sepsis. Her initial serum C reactive protein was 392\u2009mg\/L, and white cell count was 32\u00d710<jats:sup>9<\/jats:sup>\/L. The patient was treated promptly with aggressive surgical debridement and broad-spectrum antibiotics. An early multidisciplinary approach including orthopaedic surgeons, anaesthetics, intensive care, obstetrics, microbiologists and paediatrics was taken. Ultimately, both mother and child had an excellent outcome, the former of whom only had minimal soft tissue resection and primary wound closure. Emphasis is made on first treating the mother as the patient and priority.<\/jats:p>","DOI":"10.1136\/bcr-2017-222191","type":"journal-article","created":{"date-parts":[[2018,1,6]],"date-time":"2018-01-06T08:05:15Z","timestamp":1515225915000},"page":"bcr-2017-222191","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Successful management of a 24-year-old pregnant woman with necrotising fasciitis of the forearm"],"prefix":"10.1136","volume":"2018","author":[{"given":"Sam","family":"Nahas","sequence":"first","affiliation":[{"name":"Department of Trauma and Orthopaedics, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"McKirdy","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arjuna","family":"Imbuldeniya","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,1,6]]},"reference":[{"key":"2025082723112016000_2018.jan06_1.bcr-2017-222191.1","first-page":"416-31","article-title":"Necrotizing fasciitis","volume":"18","author":"WILSON","year":"1952","journal-title":"Am Surg"},{"key":"2025082723112016000_2018.jan06_1.bcr-2017-222191.2","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1089\/sur.2016.049","article-title":"Necrotizing soft tissue infections: a review","volume":"17","author":"Harbrecht","year":"2016","journal-title":"Surg Infect"},{"key":"2025082723112016000_2018.jan06_1.bcr-2017-222191.3","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.bjps.2016.05.014","article-title":"Validation of the laboratory risk indicator for necrotising fasciitis scoring system (LRINEC) in a northern European population","volume":"70","author":"Al-Hindawi","year":"2017","journal-title":"J Plast Reconstr Aesthetic Surg"},{"key":"2025082723112016000_2018.jan06_1.bcr-2017-222191.4","doi-asserted-by":"crossref","unstructured":"Williams C , Liao J , Joyce EM , et al . Altered structural and mechanical properties in decellularized rabbit carotid arteries. Acta Biomater 2009;5.doi:10.1016\/j.actbio.2008.11.028","DOI":"10.1016\/j.actbio.2008.11.028"},{"key":"2025082723112016000_2018.jan06_1.bcr-2017-222191.5","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":"2025082723112016000_2018.jan06_1.bcr-2017-222191.6","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000129486.35458.7D"},{"key":"2025082723112016000_2018.jan06_1.bcr-2017-222191.7","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200104010-00019"},{"key":"2025082723112016000_2018.jan06_1.bcr-2017-222191.8","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318263a52d"},{"key":"2025082723112016000_2018.jan06_1.bcr-2017-222191.9","first-page":"823","article-title":"Monomicrobial necrotizing fasciitis complicating pregnancy and puerperium","volume":"87","author":"McHenry","year":"1996","journal-title":"Obstet Gynecol"},{"key":"2025082723112016000_2018.jan06_1.bcr-2017-222191.10","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/S0959-289X(99)80009-0","article-title":"Necrotising fasciitis and group A streptococcus toxic shock-like syndrome in pregnancy: treatment with plasmapheresis and immunoglobulin","volume":"8","author":"Simmonds","year":"1999","journal-title":"Int J Obstet Anesth"},{"key":"2025082723112016000_2018.jan06_1.bcr-2017-222191.11","doi-asserted-by":"publisher","DOI":"10.1080\/00016340600613816"},{"key":"2025082723112016000_2018.jan06_1.bcr-2017-222191.12","doi-asserted-by":"crossref","first-page":"102","DOI":"10.4174\/astr.2015.89.2.102","article-title":"Necrotizing fasciitis of the breast in a pregnant woman successfully treated using negative-pressure wound therapy","volume":"89","author":"Lee","year":"2015","journal-title":"Ann Surg Treat Res"},{"key":"2025082723112016000_2018.jan06_1.bcr-2017-222191.13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2014\/505410","article-title":"Necrotizing fasciitis complicating pregnancy: a case report and literature review","volume":"2014","author":"Nikolaou","year":"2014","journal-title":"Case Rep Obstet Gynecol"},{"key":"2025082723112016000_2018.jan06_1.bcr-2017-222191.14","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1007\/s40121-014-0031-0","article-title":"Necrotizing fasciitis associated with pregnancy: a population-based cohort study","volume":"3","author":"Oud","year":"2014","journal-title":"Infect Dis Ther"},{"key":"2025082723112016000_2018.jan06_1.bcr-2017-222191.15","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.15.4.613-630.2002"},{"key":"2025082723112016000_2018.jan06_1.bcr-2017-222191.16","first-page":"1","article-title":"Mission statement","volume":"118203","author":"Centre for Maternal and Child Enquiries","year":"2011","journal-title":"BJOG"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-222191","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:11:31Z","timestamp":1756361491000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-222191"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,6]]},"references-count":16,"alternative-id":["10.1136\/bcr-2017-222191"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-222191","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2018,1,6]]}}}