{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T15:46:43Z","timestamp":1760888803271},"reference-count":20,"publisher":"SLACK, Inc.","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopedics"],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:p>Necrotizing fasciitis is an aggressive, invasive soft tissue infection. Because it can rapidly progress to patient instability, prompt diagnosis followed by urgent debridement is critical to decreasing mortality. Despite the importance of early diagnosis, necrotizing fasciitis remains a clinical diagnosis, with little evidence in the literature regarding the effectiveness of diagnostic tools or criteria. Common clinical findings are nonspecific, including pain, blistering, crepitus, and swelling with or without fever and a known infection source.<\/jats:p>\n          <jats:p>This article describes a patient who was transferred to the authors\u2019 institution from another hospital, where she had been taken following seizure activity and was treated with antibiotics for suspected cellulitis at the intravenous catheter placement site on her left dorsal hand. On admission to the current authors\u2019 institution, she presented with pain and swelling in the setting of significant left upper-extremity emphysema. She had undergone a left shoulder arthroscopy 4 weeks previously. Vital signs were within normal limits, and a preoperative chest radiograph was read as normal. The patient underwent an emergent fasciotomy, irrigation and debridement of the left upper extremity, and intravenous antibiotics for suspected necrotizing fasciitis. Intraoperative findings indicative of infection were absent, and a left apical pneumothorax was later found on postoperative chest imaging.<\/jats:p>\n          <jats:p>In a stable patient with a normal chest radiograph on presentation who demonstrates upper-extremity crepitus suspicious for necrotizing fasciitis, a chest computed tomography scan may be indicated to rule out an intrathoracic source.<\/jats:p>","DOI":"10.3928\/01477447-20130426-34","type":"journal-article","created":{"date-parts":[[2013,5,14]],"date-time":"2013-05-14T19:11:03Z","timestamp":1368558663000},"page":"671-675","source":"Crossref","is-referenced-by-count":7,"title":["Extensive Subcutaneous Emphysema Resembling Necrotizing Fasciitis"],"prefix":"10.3928","volume":"36","author":[{"given":"Robin N.","family":"Kamal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle M.","family":"Paci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher T.","family":"Born","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2308","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-008-3799-2"},{"issue":"1","key":"e_1_3_1_3_2","first-page":"44","article-title":"A review of necrotising fasciitis in the extremities","volume":"15","author":"Cheung JP","year":"2009","unstructured":"Cheung JP, Fung B, Tang WM, Ip WY. A review of necrotising fasciitis in the extremities. Hong Kong Med J. 2009; 15(1):44\u201352.","journal-title":"Hong Kong Med J"},{"issue":"1","key":"e_1_3_1_4_2","first-page":"7","article-title":"Necrotizing soft tissue infections: obstacles in diagnosis","volume":"182","author":"Lille ST","year":"1996","unstructured":"Lille ST, Sato TT, Engrav LH, Foy H, Jurkovich GJ. Necrotizing soft tissue infections: obstacles in diagnosis. J Am Coll Surg. 1996; 182(1):7\u201311.","journal-title":"J Am Coll Surg"},{"issue":"5","key":"e_1_3_1_5_2","first-page":"397","article-title":"Aggressive surgical management of necrotizing fasciitis serves to decrease mortality: a retrospective study","volume":"64","author":"Bilton BD","year":"1998","unstructured":"Bilton BD, Zibari GB, McMillan RW, Aultman DF, Dunn G, McDonald JC. Aggressive surgical management of necrotizing fasciitis serves to decrease mortality: a retrospective study. Am Surg. 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