case_images: PMC11253910_01
case_images: Gross image of left surgical stump from below-knee amputation showing bullae characteristic of Type II NF and dusky discoloration.
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case_images: A clinical diagnosis of necrotizing fasciitis was made and she underwent bilateral lower limb amputations (Figure 1).
case_images: A- Gross pathologic examination of right upper limb erythema and desquamation; B - Gross pathologic examination of left upper limb erythema and desquamation.
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case_images: Grossly, soft tissue exhibited the classic dermatologic clinical manifestation of sepsis and septic shock characterized by eroded bullous lesion with an erythematous base (Figures 2A and 2B).
case_images: Microphotography showing sheets of Gram-positive cocci in chains (Gram stain, 100X).
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case_images: Microscopically, fascia was necrotic without neutrophils, and Gram stain revealed sheets of Gram-positive cocci (Figure 3).
case_images: A - Microscopic image of amputation specimen showing osteonecrosis with empty osteocyte cavities surrounded by sheets of neutrophils indicative of acute osteomyelitis (H&E stain 100X); B - High power image of osteonecrosis with empty osteocyte cavities, irregular edges, and adjacent neutrophils some of which appear apoptotic (H&E stain, 400X).
case_images: autopsy-14-e2024497-g04.jpg
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case_images: Acute osteomyelitis was evident on microscopic examination following amputation (Figures 4A and 4B).