{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:38:36Z","timestamp":1787755116939,"version":"build-2784847793"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>The patient is a 16-year-old girl with history of dermatomyositis in remission for several years who presented with complaints of right thigh pain and elevated inflammatory markers. She presented to the Emergency Room (ER) on separate occasions and was diagnosed with right lower extremity necrotizing fasciitis secondary to ruptured appendix. She underwent 11 surgical procedures and extended hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This case is a unique presentation of ruptured appendicitis without abdominal pain that presented as right lower extremity necrotizing fasciitis and posed a diagnostic challenge. This case illustrates the importance of diligent evaluation and aggressive surgical management in musculoskeletal infections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.20.00250","type":"journal-article","created":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T08:38:21Z","timestamp":1614242301000},"page":"e20.00250","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Necrotizing Fasciitis of the Right Lower Extremity from Ruptured Appendicitis"],"prefix":"10.2106","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8087-5453","authenticated-orcid":false,"given":"Shawn","family":"Funk","sequence":"first","affiliation":[{"name":"Section Pediatric Orthopaedic Surgery, Orthopaedic Surgery Baylor College of Medicine, Children's Hospital of San Antonio, San Antonio, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7406-853X","authenticated-orcid":false,"given":"Kelley","family":"Warren","sequence":"additional","affiliation":[{"name":"Section Pediatric Orthopaedic Surgery, Orthopaedic Surgery Baylor College of Medicine, Children's Hospital of San Antonio, San Antonio, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7828-1699","authenticated-orcid":false,"given":"Thomas S.","family":"DeNapoli","sequence":"additional","affiliation":[{"name":"Department Pathology, Children's Hospital of San Antonio, San Antonio, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5424-2166","authenticated-orcid":false,"given":"Ian C.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Pediatric General Surgery, Children's Hospital of San Antonio, San Antonio, 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