{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T17:41:42Z","timestamp":1793122902912,"version":"4.5.0"},"reference-count":0,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2000,1,1]],"date-time":"2000-01-01T00:00:00Z","timestamp":946684800000},"content-version":"vor","delay-in-days":1095,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Infectious Diseases in Obstetrics and Gynecology"],"published-print":{"date-parts":[[1997,1]]},"abstract":"<jats:p><jats:italic>Background:<\/jats:italic> Necrotizing fasciitis is a rare condition. We report a fatal case arising from an episiotomy in a previously healthy woman.<\/jats:p><jats:p><jats:italic>Case:<\/jats:italic> A healthy 23\u2010year\u2010old prima gravida white female underwent vaginal delivery with repair of a proctoepisiotomy. Eighty\u2010four hours postpartum, she developed increasing perineal swelling with severe pain. She presented on the 4th postpartum day with edema, erythema localized to the perineum, and vital signs significant only for tachycardia of 120\/min. With a leukocytosis of 45,000\/\u03bcl (87%) neutrophils, she was admitted to the hospital with an initial diagnosis of perineal cellulitis and empirically started on broad\u2010spectrum intravenous antibiotic therapy. The patient\u2032s condition continued to deteriorate and she was then transferred to our facility on postpartum day 9 where a team performed two radical debridements of all necrotic tissue. Despite this and a broadened antibiotic coverage, the patient eventually experienced cardiopulmonary arrest and died on postpartum day 12.<\/jats:p><jats:p><jats:italic>Conclusion:<\/jats:italic> Necrotizing fasciitis must be considered in the differential diagnosis of the postpartum patient presenting with severe vulvar pain and erythema. Our patient exemplifies the obscure presentation with seemingly minimal skin changes. Any delay in diagnosis and treatment, which must include expeditious aggressive surgical debridement, will likely result in severe morbidity or mortality.<\/jats:p>","DOI":"10.1155\/s1064744997000598","type":"journal-article","created":{"date-parts":[[2007,3,7]],"date-time":"2007-03-07T13:01:59Z","timestamp":1173272519000},"page":"341-344","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Maternal Death From Postpartum Necrotizing Fasciitis Arising in an Episiotomy: A Case Report"],"prefix":"10.1155","volume":"5","author":[{"given":"Catherine M.","family":"Lynch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna M.","family":"Pinelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Wayne","family":"Cruse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William N.","family":"Spellacy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John T.","family":"Sinnott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron G.","family":"Shashy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[1997,11,3]]},"container-title":["Infectious Diseases in Obstetrics and Gynecology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/idog\/1997\/796072.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/idog\/1997\/796072.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/S1064744997000598","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T21:13:23Z","timestamp":1723065203000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/S1064744997000598"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1997,1]]},"references-count":0,"aliases":["10.1002\/(sici)1098-0997(1997)5:5<341::aid-idog6>3.0.co;2-y"],"journal-issue":{"issue":"5","published-print":{"date-parts":[[1997,1]]}},"alternative-id":["10.1155\/S1064744997000598"],"URL":"https:\/\/doi.org\/10.1155\/s1064744997000598","archive":["Portico"],"relation":{},"ISSN":["1064-7449"],"issn-type":[{"value":"1064-7449","type":"print"}],"subject":[],"published":{"date-parts":[[1997,1]]},"assertion":[{"value":"1997-06-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1997-11-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1997-11-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}