Erythema multiforme controversies and recent advances.
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Biomedical subjects
Publications and source records attributed to G N Goldberg.
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Necrotizing fasciitis exists on a continuum of soft tissue infections between cellulitis and myonecrosis. It has been uncommonly reported in infancy (1-10). The diagnosis depends on recognition of the characteristic rapidly progressive clinical course and demonstration of full-thickness skin necrosis with involvement of the fascial planes overlying the muscle. The organisms most often recovered are beta-hemolytic Streptococcus or Staphylococcus aureus, but other aerobic and anaerobic organisms in single or mixed infection have been reported (1, 2, 11, 12). This infection has a significant mortality rate, necessitating early, aggressive, specific medical and surgical treatment.
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A male infant infected in utero with Epstein-Barr virus (EBV) demonstrated a syndrome of multiple congenital anomalies (micrognathia, cryptorchidism, central cataracts), hypotonia, thrombocytopenia, persistent monocytosis, proteinuria, and multiple areas of metaphysitis at birth. Lymphocytes were Epstein-Barr nuclear antigen (EBNA) positive (18%) and persisted in culture for three months. He had antibody to early antigen (anti-EA), IgM-viral capsid (anti-VCA), and EBNA (anti-EBNA) detectable at 22 days of age. All attempts to isolate infectious agents or to serologically identify other infectious causes for his syndrome were negative.
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