Abstract
Necrotizing fasciitis which is commonly known as “Flesh-Eating Disease” is a bacterial infection that spreads quickly and kills the body’s soft-tissue. The paucity of specific cutaneous signs to distinguish necrotizing fasciitis from other soft tissue infections such as cellulitis makes the diagnosis extremely difficult. Modalities such as Computed tomography, Magnetic resonance imaging (MRI), and biopsy have been shown to be useful in the early recognition of necrotizing fasciitis, and routine application of these modalities in the evaluation of soft tissue infections has been limited by cost and availability. Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score or the LRINEC scoring system, devised by Wong et al 36 in 2005 is an easy method and modality to follow and is also cost effective. Early diagnosis of necrotizing soft tissue infections is important for timely surgical intervention, but presenting physical exam findings can vary, so misdiagnosis is common(1). Total of 100 subjects were studied by applying LRINEC score, who presented to KIMS Hospital, Bangalore with symptoms suggestive of soft tissue infections during the study period.
Keywords: LRINEC Scoring System, Necrotising Fasciitis (NF), C Reactive Protein, Poly Microbial Infections.
References
- Goh T, Goh LG, Ang CH, Wong CH.Early diagnosis of necrotizing fasciitis. Br J Surg. 2014;101(1):e119-e125. doi:10.1002/bjs.9371.
- Anaya DA, Dellinger EP. Necrotizing soft-tissue infection: Diagnosis and management. Clin Infect Dis.2007;44: 705–10. [PubMed]
- Elliot DC, Kufera JA, Myers RA. Necrotizing soft tissue infections. Risk factors for mortality and strategies for management. Ann Surg1996; 224(5):672-83.
- Mathews MS, Raman A, Nair A. Nosocomial zygomycotic post-surgical necrotizing fasciitis in a healthy adult caused by Apophysomyceselegansin south India. J Med Vet Mycol. 1997;35:61–3. [PubMed]
- Wvoski MG, Santora TA. Necrotizing fascitis: CT characteristics. 1997;203:859–863.[PubMed]
- Schmid M R, Kossmann T, DueweII S. Differentiation of Necrotizing Fasciitis and Cellulitis Using MR Imaging. AJR. Mar 1998; 170: 615-620.
- Chao W-N, Tsai S-J, Tsai C-F, et al.The Laboratory Risk Indicator for Necrotizing Fasciitis score for discernment of necrotizing fasciitis originated from Vibrio vulnificus infections. J Trauma Acute Care Surg. 2012;73(6):1576-1582.
- Descamps V, Aitken J, Lee MG. Hippocrates on necrotizing fasciitis. Lancet 1994; 344:556.
- Bernal NP, Latenser BA, Born JM, Liao J.Trends in 393 necrotizing acute soft tissue infection patients 2000-2008. 2012;38(2):252-260.
- Swain RA, Hatcher JC, Azadian BS, Soni N, De Souza B.A five-year review of necrotising fasciitis in a tertiary referral unit. Ann R CollSurg Engl. 2013;95(1):57-60. Townsend: Sabiston Textbook of Surgery, 18th Ed.p-2011.
- Chan T, Yaghoubian A, Rosing D, Kaji A, de Virgilio C.Low sensitivity of physical examination findings in necrotizing soft tissue infection is improved with laboratory values: a prospective study. Am J Surg. 2008;196(6):926-930; discussion 930.
- Nissar Shaiks, A Decade of Surgical Intensive Care Experience, Indian Journal of Critical Care & Medicine, 2006, Vol:10, Issue:4, Pages:225-229.
Corresponding Author
Dr Athirath Reddy K
Resident in Dept of Surgery, Kempegowda Institute of Medical Sciences and Research Centre K.R Road, VV Puram Bangalore Pin:560004, India
This email address is being protected from spambots. You need JavaScript enabled to view it., Ph:+919908877878
DOI: https://dx.doi.org/10.18535/jmscr/v6i7.183
