{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T07:16:45Z","timestamp":1763018205661},"reference-count":9,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2020,4,27]],"date-time":"2020-04-27T00:00:00Z","timestamp":1587945600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinics and Practice"],"abstract":"<jats:p>Necrotizing fasciitis is a severe and progressive infection of deep soft tissues which results in destruction of the fascia and overlying subcutaneous fat. We report a case of a 45-year-old diabetic gentleman who initially presented with left shoulder pain, which was treated symptomatically. Upon representation, he had fever and the pain extended to his left upper back. There was a warm, firm and mildly tender purplish swelling on his mid to the left upper back. Blood tests revealed significantly elevated white cell counts and C-reactive protein. A CT thorax showed extensive soft tissue gas within the deep and superficial fascial layers of his left upper back. Necrotizing fasciitis was confirmed intraoperatively. The diagnosis of this condition is often difficult as early symptoms can be mild and nonspecific. A high Laboratory Risk Indicator for NECrotizing fasciitis (LRINEC) score may be helpful to rule in this diagnosis and guide further management.<\/jats:p>","DOI":"10.4081\/cp.2020.1218","type":"journal-article","created":{"date-parts":[[2020,4,28]],"date-time":"2020-04-28T03:41:13Z","timestamp":1588045273000},"page":"1218","source":"Crossref","is-referenced-by-count":1,"title":["Necrotizing Fasciitis of the Upper Back Presenting with Left Shoulder Pain"],"prefix":"10.3390","volume":"10","author":[{"given":"Mohamad Zikri","family":"Mohamad Isa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed-Syarif","family":"Mohamed-Yassin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roqiah Fatmawati","family":"Abdul Kadir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,4,27]]},"reference":[{"issue":"3","key":"ref1","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/s11751-011-0116-1","article-title":"Necrotizing fasciitis of the extremities: a prospective study","volume":"6","author":"Espandar","year":"2011","journal-title":"Strategies Trauma Limb Reconstr"},{"issue":"23","key":"ref2","doi-asserted-by":"crossref","first-page":"2253","DOI":"10.1056\/NEJMra1600673","article-title":"Necrotizing Soft-Tissue Infections","volume":"377","author":"Stevens","year":"2017","journal-title":"NEJM"},{"issue":"3","key":"ref3","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1097\/TA.0b013e318232a6b3","article-title":"Necrotizing fasciitis: classification, diagnosis, and management","volume":"72","author":"Lancerotto","year":"2012","journal-title":"J. Trauma Acute Care Surg"},{"issue":"3","key":"ref4","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1086\/427286","article-title":"Correlation of Histopathologic Findings with Clinical Outcome in Necrotizing Fasciitis","volume":"40","author":"Bakleh","year":"2005","journal-title":"Clin. Infect. Dis"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"e4274","DOI":"10.1136\/bmj.e4274","article-title":"Necrotising fasciitis","volume":"345","author":"Sultan","year":"2012","journal-title":"BMJ"},{"issue":"4","key":"ref6","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.amsu.2015.09.005","article-title":"Clinical presentations and outcomes of necrotizing fasciitis in males and females over a 13-year period","volume":"4","author":"Shaikh","year":"2015","journal-title":"Ann Med Surg (Lond)"},{"issue":"7","key":"ref7","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1097\/01.CCM.0000129486.35458.7D","article-title":"The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections","volume":"32","author":"Wong","year":"2004","journal-title":"Crit. Care Med"},{"issue":"2","key":"ref8","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1007\/s11547-015-0575-4","article-title":"The role of contrast enhanced computed tomography in the diagnosis of necrotizing fasciitis and comparison with the laboratory risk indicator for necrotizing fasciitis (LRINEC)","volume":"121","author":"Carbonetti","year":"2016","journal-title":"Radiol Med"},{"issue":"1033","key":"ref9","doi-asserted-by":"crossref","first-page":"20130560","DOI":"10.1259\/bjr.20130560","article-title":"MRI in necrotizing fasciitis of the extremities","volume":"87","author":"Ali","year":"2013","journal-title":"The Br J Radiol"}],"container-title":["Clinics and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.clinicsandpractice.org\/index.php\/cp\/article\/download\/1218\/1030","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.mdpi.com\/2039-7283\/10\/1\/1218\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T07:03:30Z","timestamp":1644476610000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-7283\/10\/1\/1218"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,27]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,3]]}},"alternative-id":["cp.2020.1218"],"URL":"https:\/\/doi.org\/10.4081\/cp.2020.1218","relation":{},"ISSN":["2039-7283"],"issn-type":[{"value":"2039-7283","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,27]]}}}