Necrotizing fasciitis secondary to chickenpox infection in children.
Bibliographic record
Abstract
BACKGROUND: Necrotizing fasciitis is an uncommon but serious complication of chickenpox infection in young children. Because many of these infections affect the musculoskeletal tissues, orthopedic surgeons are often the first caregivers to be involved in diagnosis and treatment. Our objective was to review the diagnostic features of necrotizing fasciitis and analyze treatment methods to control and eradicate the musculoskeletal infection. DESIGN: A review. SETTING: The Children's Hospital of Eastern Ontario, Ottawa, a major Canadian pediatric trauma and referral centre. PATIENTS: Five children who presented with necrotizing fasciitis secondary to chickenpox infection. INTERVENTION: Surgical debridement of the involved area of necrotizing fasciitis and intravenous antibiotic treatment with clindamycin and penicillin. MAIN OUTCOME MEASURES: Complications outcome. RESULTS: The average age of the 5 children at presentation was 3.8 years (range from 2.9-5.8 yr). The necrotizing fasciitis involved the lower extremity in 5 children, the upper extremity in 3, and the abdomen, chest, neck and back in 1 child each. One child presented with involvement of all 4 extremities. In 4 children, culture specimens grew group A beta-hemolytic Streptococcus. They all survived and all limbs were salvaged, although secondary closure and skin grafting were required. At an average follow-up of 1 year, each child had fully recovered with no loss of muscle function. CONCLUSIONS: Necrotizing fasciitis should be suspected in any child with a history of varicella infection and an increasing complaint of pain and swelling in an extremity or other body area associated with increasing fever, erythema, lethargy and irritability. Emergent surgical debridement and intensive antibiotic therapy are essential to prevent muscle necrosis, major limb dysfunction and death.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".