title: Necrotizing myositis in a neutropenic patient: the use of ultrasound in the diagnosis of atypical presentations.
abstract: We report a case of fatal necrotizing soft tissue infection (NSTI) due to Clostridium perfringens (CP) in a neutropenic patient with diabetes mellitus. As in many cases, by the time a diagnosis was made, the condition had rapidly progressed to its late stages, resulting in a fatal outcome. The emergency physician should be aware of NSTI as a complication when patients present with pain out of proportion to physical findings and/or signs of soft tissue compromise. Negative prognostic factors for survival are diabetes mellitus, immunosuppression, age, and toxic shock syndrome. A bedside ultrasound scan allows for rapid evaluation in time-sensitive critically ill patients and can promote prompt treatment without the need to delay for further imaging studies.
authors.affiliation: Department of Trauma and Orthopedics, Hospital Universitario Fundacion Alcorcon, Calle Budapest 1, 28922 Madrid, Spain.
authors.forename: Maria Del Carmen
authors.initials: Mdel C
authors.lastname: Torrejón
authors.affiliation: Department of Surgery, Hospital Universitario Fundacion Alcorcon, Calle Budapest 1, 28922 Madrid, Spain.
authors.forename: Edgardo
authors.initials: E
authors.lastname: Celi
authors.affiliation: Department of Anesthesiology, Hospital Universitario Fundacion Alcorcon, Calle Budapest 1, 28922 Madrid, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Cancho
authors.affiliation: School of Medicine, University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PT, UK.
authors.forename: Ailie
authors.initials: A
authors.lastname: Knox
authors.affiliation: Infectious Diseases/Internal Medicine Unit, Hospital Universitario Fundacion Alcorcon, Calle Budapest 1, 28922 Madrid, Spain.
authors.forename: Cesar
authors.initials: C
authors.lastname: Henriquez-Camacho