{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T06:08:07Z","timestamp":1784268487103,"version":"3.55.0"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Necrotizing soft tissue infections (NSTIs) are rare but life-threatening conditions requiring early diagnosis and aggressive multidisciplinary management. Necrotizing myositis (NM) is an uncommon and particularly severe manifestation, often associated with diagnostic delay and poor outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report the case of a 57-year-old man presenting with mild pelvic pain radiating to the posterior thigh. Contrast-enhanced computed tomography revealed a presacral abscess with an extrasphincteric fistulous tract extending into the posterior thigh musculature. Surgical exploration confirmed necrotizing fasciitis with myonecrosis caused by Group A Streptococcus. The patient underwent repeated surgical debridement, broad-spectrum antimicrobial therapy, and adjunctive hyperbaric oxygen therapy, resulting in progressive clinical improvement and complete recovery at six-month follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This case highlights the importance of early imaging, prompt source control, and multidisciplinary management in atypical NSTIs, while illustrating the potential adjunctive role of HBO\n                      <jats:sub>2<\/jats:sub>\n                      in selected patients.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1906467","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:43:10Z","timestamp":1784266990000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Necrotizing myositis secondary to a pararectal fistula: diagnostic challenges and multidisciplinary management"],"prefix":"10.3389","volume":"13","author":[{"given":"Andrea Neville","family":"Cracchiolo","sequence":"first","affiliation":[{"name":"Unit of 118 Emergency Medical Services and Hyperbaric Medicine, ARNAS Civico Di Cristina Benfratelli Hospital","place":["Palermo, Sicily, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela Maria","family":"Palma","sequence":"additional","affiliation":[{"name":"Department of Neuroscience and Emergency with Trauma Center, A.O.O.R. Villa Sofia Cervello","place":["Palermo, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Palmeri","sequence":"additional","affiliation":[{"name":"Unit of 118 Emergency Medical Services and Hyperbaric Medicine, ARNAS Civico Di Cristina Benfratelli Hospital","place":["Palermo, Sicily, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Cracchiolo","sequence":"additional","affiliation":[{"name":"Vita-Salute San Raffaele University","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Nicosia","sequence":"additional","affiliation":[{"name":"Unit of 118 Emergency Medical Services and Hyperbaric Medicine, ARNAS Civico Di Cristina Benfratelli Hospital","place":["Palermo, Sicily, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Genco","sequence":"additional","affiliation":[{"name":"Unit of 118 Emergency Medical Services and Hyperbaric Medicine, ARNAS Civico Di Cristina Benfratelli Hospital","place":["Palermo, Sicily, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Profera","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone","place":["Palermo, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santi Maurizio","family":"Raineri","sequence":"additional","affiliation":[{"name":"Unit of 118 Emergency Medical Services and Hyperbaric Medicine, ARNAS Civico Di Cristina Benfratelli Hospital","place":["Palermo, Sicily, Italy"]},{"name":"Department of Anaesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone","place":["Palermo, Italy"]},{"name":"Department of Precision Medicine Disciplines in the Medical Area Surgical and Critical Care, University of Palermo","place":["Palermo, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Accurso","sequence":"additional","affiliation":[{"name":"Unit of 118 Emergency Medical Services and Hyperbaric Medicine, ARNAS Civico Di Cristina Benfratelli Hospital","place":["Palermo, Sicily, Italy"]},{"name":"Department of Anaesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone","place":["Palermo, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2253","DOI":"10.1056\/NEJMra1600673","article-title":"Necrotizing soft-tissue infections","volume":"377","author":"Stevens","year":"2017","journal-title":"N Engl J Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.idc.2007.12.001","article-title":"Management of skin and soft-tissue infections in the emergency 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