{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T02:11:25Z","timestamp":1792721485197,"version":"4.5.0"},"reference-count":53,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This is a prospective study of the clinico-etiologic profile and factors affecting outcomes in 40 children managed for necrotizing fasciitis (NF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Demographic details, clinical characteristics, and laboratory parameters were recorded, and the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score was calculated. Primary outcome (survival vs. nonsurvival) was noted, and prognostic factors were identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Initiating factors included boils (45%), i.v. cannula extravasations (22.5%), and blunt trauma (17.5%). Lesion (s) were predominantly on the lower limbs (35%) and trunk (25%). Twenty-two patients (55%) had &lt;5% body surface area (BSA) involved. Severely deranged clinical and laboratory parameters were common. Ultrasound localized fluid collections. Pus cultures showed methicillin-resistant\n                      <jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic>\n                      (52.5%), methicillin-sensitive\n                      <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                      [27.5%], and polymicrobial growth (20%). Blood culture was positive in 24 patients (60%). Most isolates were sensitive to clindamycin and amoxy-clavulanate. Prognostic factors for mortality (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 6; 15%) included categorization as \u201cSick,\u201d BSA involvement &gt;10%, thrombocytopenia, raised serum creatinine, late debridement, and polymicrobial blood culture isolates. All six nonsurvivors had a LRINEC score of \u22658 and positive blood cultures. Six patients (20.7%) developed unsightly scars and 5 (17.24%) contractures across joints.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Pediatric NF has significant morbidity and mortality. Patients with adverse prognostic factors can benefit from early referral to a facility with a critical care unit. Adequate wound management is essential to minimize residual deformity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jiaps.jiaps_222_21","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T10:12:35Z","timestamp":1716545555000},"page":"577-584","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Morbidity and mortality of necrotizing fasciitis and their prognostic factors in children"],"prefix":"10.4103","volume":"27","author":[{"given":"Dilip Kumar","family":"Singh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Kapoor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Partap Singh","family":"Yadav","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonal","family":"Saxena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiran","family":"Agarwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi S.","family":"Solanki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subhasis Roy","family":"Choudhury","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiv","family":"Chadha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-13-20240905","doi-asserted-by":"crossref","first-page":"1892","DOI":"10.1016\/j.jpedsurg.2007.07.018","article-title":"Necrotizing fasciitis in children: Diagnostic and therapeutic aspects","volume":"42","author":"Bing\u00f6l-Kolo\u011flu","year":"2007","journal-title":"J Pediatr Surg"},{"key":"R2-13-20240905","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1001\/archderm.138.7.893","article-title":"Necrotizing fasciitis: Report of 39 pediatric cases","volume":"138","author":"Fustes-Morales","year":"2002","journal-title":"Arch Dermatol"},{"key":"R3-13-20240905","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1089\/sur.2016.200","article-title":"Management and novel adjuncts of necrotizing soft tissue infections","volume":"18","author":"Cocanour","year":"2017","journal-title":"Surg Infect (Larchmt"},{"key":"R5-13-20240905","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.jamcollsurg.2008.10.032","article-title":"Necrotizing fasciitis: Current concepts and review of the literature","volume":"208","author":"Sarani","year":"2009","journal-title":"J Am Coll Surg"},{"key":"R6-13-20240905","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1007\/s00068-017-0792-8","article-title":"Necrotizing fasciitis: Treatment concepts and clinical results","volume":"44","author":"Leiblein","year":"2018","journal-title":"Eur J Trauma Emerg Surg"},{"key":"R7-13-20240905","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1001\/archpedi.1973.04160040087018","article-title":"Acute necrotizing fasciitis in childhood. 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