1. ¹Intermountain Healthcare, Ogden and Salt Lake City, UT, USA
2. ²Department of Pathology, Primary Children's Medical Center, Intermountain Healthcare, and the University of Utah College of Medicine, Salt Lake City, UT, USA
3. ³Christensen Dental, 700 N. Fairfield Road, Layton, UT, USA

Correspondence: Dr R Christensen, Neonatology, Intermountain Healthcare, 4403 Harrison Blvd, Ogden, UT 84403, USA. E-mail: rdchris4@ihc.com

Received 11 October 2006; Revised 19 February 2007; Accepted 23 February 2007.

Abstract

Necrotizing fasciitis in the neonatal period is a rare, life-threatening condition. Previous cases of neonatal necrotizing fasciitis in the perianal region were speculated to have been initiated by rectal mucosal trauma secondary to rectal temperature measurements. We observed a case of fatal perianal necrotizing fasciitis in a neonate where the process began as a red ring surrounding the anus and guiac-positive stools, detected after a rectal temperature measurement. We speculate that the perianal necrotizing fasciitis that subsequently developed might have been initiated by a minor rectal mucosal injury, and we investigated the instrument used for the rectal temperature measurement to assess any potential areas on the probe sheath cover that might cause a minor injury. Each probe sheath cover examined had three areas that, in our opinion, could possibly generate a minor mucosal injury.