Evidence map›Paper›PMID 30071825›Full record

ArticleBMC infectious diseases2018

Fatal Fournier's gangrene caused by Clostridium ramosum in a patient with central diabetes insipidus and insulin-dependent diabetes mellitus: a case report.

Noriyoshi Takano, Midori Sasaki Yatabe, Junichi Yatabe, Masaaki Kato, Daisuke Sueoka, Shigekazu Iguchi, Atsushi Yoshida, Yutaka Uzawa, Ken Kikuchi, Kimitaka Tani and 7 more

Open access · goldAbstract readCase Reports
In one paragraph

Article in BMC infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Heliyon · 2024
    Article
  4. Review
  5. Article
  6. Article
  7. Practical Review of the Current Management of Fournier's Gangrene.Plastic and reconstructive surgery. Global open · 2022
    Review
  8. Article
  9. Article
  10. Access microbiology · 2020
    Article
  11. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 1 institution in 1 country.

Noriyoshi TakanoDepartment of Medicine II, Endocrinology and Hypertension, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjyuku-ku, Tokyo, 162-8666, Japan.
Midori Sasaki YatabeDepartment of Medicine II, Endocrinology and Hypertension, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjyuku-ku, Tokyo, 162-8666, Japan.
Junichi YatabeDepartment of Medicine II, Endocrinology and Hypertension, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjyuku-ku, Tokyo, 162-8666, Japan. jyatabe@endm.twmu.ac.jp.
Masaaki KatoMedical Training Center for Graduates, Tokyo Women's Medical University, Tokyo, Japan.
Daisuke SueokaMedical Training Center for Graduates, Tokyo Women's Medical University, Tokyo, Japan.
Shigekazu IguchiDepartment of Infectious Diseases, Tokyo Women's Medical University, Tokyo, Japan.
Atsushi YoshidaDepartment of Infectious Diseases, Tokyo Women's Medical University, Tokyo, Japan.
Yutaka UzawaDepartment of Infectious Diseases, Tokyo Women's Medical University, Tokyo, Japan.
Ken KikuchiDepartment of Infectious Diseases, Tokyo Women's Medical University, Tokyo, Japan.
Kimitaka TaniDepartment of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
Shinpei OgawaDepartment of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
Michio ItabashiDepartment of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
Masakazu YamamotoDepartment of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
Daisuke WatanabeDepartment of Medicine II, Endocrinology and Hypertension, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjyuku-ku, Tokyo, 162-8666, Japan.
Takashi AndoDepartment of Medicine II, Endocrinology and Hypertension, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjyuku-ku, Tokyo, 162-8666, Japan.
Satoshi MorimotoDepartment of Medicine II, Endocrinology and Hypertension, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjyuku-ku, Tokyo, 162-8666, Japan.
Atsuhiro IchiharaDepartment of Medicine II, Endocrinology and Hypertension, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjyuku-ku, Tokyo, 162-8666, Japan.
Tokyo Women's Medical University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClostridium ramosum is a generally non-pathogenic enteric anaerobe, and Fournier's gangrene is a rare necrotizing soft tissue infection with male predisposition affecting the perineum and the genital area. We report, to our knowledge, the first case of Fournier's gangrene caused by C. ramosum in a female patient with multiple underlying conditions. CASE PRESENTATION: A 44-year-old woman with a 6-year history of insulin-dependent diabetes mellitus after total pancreatectomy and an 11-year history of central diabetes insipidus developed a pain in the genital area after a month of urinary catheter use. The lower abdominal pain worsened gradually over 2 weeks, and the pain, general fatigue, and loss of appetite prompted the patient's hospital admission. As she had severe edema in her pelvic and bilateral femoral areas, ceftriaxone was started empirically after collecting two sets of blood cultures. On hospital day 2, CT examination revealed the presence of necrotizing faciitis in the genital and pelvic areas, and the antibiotics were changed to a combination of meropenem, vancomycin, and clindamycin. Gram-positive cocci and gram-positive rods were isolated from blood cultures, which were finally identified as Streptococcus constellatus and C. ramosum using superoxide dismutase and 16S rDNA sequencing. An emergent surgery was performed on hospital day 2 to remove the affected tissue. Despite undergoing debridement and receiving combined antimicrobial chemotherapies, the patient's clinical improvement remained limited. The patient's condition continued to deteriorate, and she eventually died on hospital day 8. In the present case, the underlying diabetes mellitus, urinary incontinence due to central diabetes insipidus, undernutrition, and edema served as the predisposing conditions.

conclusionsC. ramosum is a potentially opportunistic pathogen among immunosuppressed persons and a rare cause of necrotizing fasciitis.

Indexed as

ClostridiumAdultClostridium InfectionsDiabetes Insipidus, NeurogenicDiabetes Mellitus, Type 1Fatal OutcomeFemaleFournier GangreneHumansClostridium ramosumFournier’s gangreneNecrotizing fasciitisOpportunistic infection

Identifiers

PMID30071825
PMCPMC6090845
OpenAlexW2887057432

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.