title: Necrotising fasciitis caused by adulterated traditional Asian medicine: a case report.
abstract: Necrotising fasciitis can be life threatening, requiring prompt diagnosis and surgical debridement. We report a case of necrotising fasciitis caused by an adulterate traditional Asian medication--Jamu Pegal Linu, containing toxic levels of phenylbutazone and dipyrone. The patient presented with severe neutropenia and sepsis. An urgent extensive debridement was carried out (within 6 hours of presentation). Repeated debridements were performed on days 2 and 5, augmented with antibiotics and granulocyte colony-stimulating factor.
authors.affiliation: Department of Orthopaedic Surgery, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074. hitendra_doshi@yahoo.com
authors.forename: Hitendra K
authors.initials: HK
authors.lastname: Doshi
authors.forename: Joseph
authors.initials: J
authors.lastname: Thambiah
authors.forename: Cheng Leng
authors.initials: CL
authors.lastname: Chan
authors.forename: Min En
authors.initials: ME
authors.lastname: Nga
authors.forename: Paul Ananth
authors.initials: PA
authors.lastname: Tambyah
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D003646:Debridement; D004177:Dipyrone / Q000009:adverse effects*; D004340:Drug Contamination; D019115:Fasciitis, Necrotizing / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007866:Leg; D008279:Magnetic Resonance Imaging; D008297:Male; D008518:Medicine, East Asian Traditional / Q000009:adverse effects*; D008875:Middle Aged; D010653:Phenylbutazone / Q000009:adverse effects*
chemical_list: D000890:Anti-Infective Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004177:Dipyrone; D010653:Phenylbutazone