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Benign muscular emphysema mimicking gas-forming infection
  1. Matthias Nissen1,
  2. Micha Bahr1,
  3. Volker Sander1,
  4. Werner Finke2,
  5. Ralf-Bodo Tröbs1
  1. 1Department of Pediatric Surgery, St. Mary’s Hospital, St. Elisabeth Group, Ruhr-University of Bochum, Herne, Germany
  2. 2Department of Anesthesiology and Surgical Intensive Care, St. Mary’s Hospital, St. Elisabeth Group, Ruhr-University of Bochum, Herne, Germany
  1. Correspondence to Dr. Matthias Nissen, Department of Pediatric Surgery, St. Mary’s Hospital, St. Elisabeth Group, Ruhr-University of Bochum, Herne D- 44627, Germany; matthias.nissen{at}elisabethgruppe.de

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A 13-year-old boy presented 24 hours after noticing an insect bite on his left forearm (figure 1A). Perilesional erythema with a blister, crepitation and progressive pain started 12 hours before presentation. On admission, vital signs, inflammatory parameters, creatinine (kinase) and lactate were normal. Left arm and ventral hemithorax were swollen with crepitation, chest physical examination was inconspicuous. CT showed subfascial emphysema (figure 1B).

Figure 1

(A) Insect bite with perilesional erythema on the left forearm. (B) Non-enhanced CT depicting gas …

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