title: Cyclic neutropenia with a novel gene mutation presenting with a necrotizing soft tissue infection and severe sepsis: case report.
abstract: BACKGROUND
  Cyclic neutropenia is a rare disease. We report a 31-month-old girl with congenital cyclic neutropenia with a novel mutation in the ELANE gene who developed an acute necrotizing soft-tissue infection on her left axillary legion.
  
  
  METHODS
  A 31-month-old girl was admitted to our pediatric emergency room because of a necrotizing soft tissue infection of the left axillary area. The infection progressed rapidly and resulted in septic shock. Despite a medical treatment and surgical debridement, the sepsis was not controlled, and severe inflammation developed. After applying of negative-pressure wound therapy, her clinical symptoms improved. Finally, she was diagnosed with cyclic neutropenia with a novel genetic mutation. One month after admission, she was discharged with a completely recovered wound and no need for skin grafting.
  
  
  CONCLUSIONS
  Both adequate medical treatment and effective control of the source of infection are critically important to reduce morbidity in such complex cases of necrotizing fasciitis as appeared in an immunocompromised pediatric patient.
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, Korea University College of Medicine, 73 Inchonro, Sungbuk-gu, Anam-dong, Seoul, 136-705, Korea. drboo@korea.ac.kr.
authors.forename: Yoon Jung
authors.initials: YJ
authors.lastname: Boo
authors.affiliation: Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea. myunghyun.nam@gmail.com.
authors.forename: Myung Hyun
authors.initials: MH
authors.lastname: Nam
authors.affiliation: Department of Pediatric, Korea University College of Medicine, Seoul, Korea. frinky@hanmail.net.
authors.forename: Eun Hee
authors.initials: EH
authors.lastname: Lee
authors.affiliation: Department of Pediatric, Korea University College of Medicine, Seoul, Korea. kumc@hanmail.net.
authors.forename: Kuang Chul
authors.initials: KC
authors.lastname: Lee
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001365:Axilla; D002675:Child, Preschool; D003646:Debridement; D019115:Fasciitis, Necrotizing / Q000276:immunology* / Q000628:therapy; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D019272:Leukocyte Elastase / Q000235:genetics; D020125:Mutation, Missense; D054843:Negative-Pressure Wound Therapy; D009503:Neutropenia / Q000151:congenital* / Q000235:genetics; D012772:Shock, Septic / Q000276:immunology* / Q000628:therapy; D018461:Soft Tissue Infections / Q000276:immunology* / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents; D019272:Leukocyte Elastase