Background: The Laboratory Risk Indicator for Necrotizing Fasciitis score (LRINEC) is a simple tool used to support early diagnosis of Necrotizing Fasciitis (NF). The aim of this study was to investigate whether the LRINEC is suitable as a progression and prognosis parameter in patients with NF. Methods: In this retrospective study, laboratory data of 70 patients with NF were analyzed. The LRINEC was calculated for every patient at the time of hospital admission and postoperatively after surgical interventions. Furthermore, the LRINEC was examined as a prognostic factor for survival. Results: The overall lethality of our series was 20 out of 70 (28.6%). A highly significant LRINEC decrease was found for serial debridements. The largest decrease was observed after the first debridement. There was a significant difference between the initial LRINEC of deceased and surviving patients. A cut off value of >6.5 (7 LRINEC points) resulted in an optimal constellation of sensitivity (70%) and specificity (60%) to predict lethality in patients with NF. Conclusions: The LRINEC significantly decreases after surgical debridement. An initial LRINEC equal or greater than seven is an independent prognostic marker for lethality and can help to identify high-risk patients.
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http://dx.doi.org/10.3390/jcm11133583 | DOI Listing |
Diagnostics (Basel)
December 2024
Department of General Surgery, Faculty of Medicine, Harran University, Şanlıurfa 63300, Turkey.
Objectives: Fournier's gangrene is an aggressive, rapidly progressing, and life-threatening necrotizing fasciitis of the perineal and genital regions. Various scoring systems have been developed for predicting survival and prognosis in Fournier's gangrene. This retrospective study aimed to evaluate the effectiveness of the newly developed Fournier's gangrene mortality index (FGMI) in predicting mortality associated with Fournier's gangrene.
View Article and Find Full Text PDFCureus
November 2024
Department of General Surgery, Sree Balaji Medical College and Hospital, Chennai, IND.
Plast Reconstr Surg Glob Open
December 2024
Plastic Surgery Division, King Saud Medical City, Riyadh, Saudi Arabia.
This report describes a rare case of necrotizing fasciitis (NF) in a previously healthy 9-year-old girl, emphasizing the complexities and urgent needs associated with its diagnosis and treatment in children. NF, a severe soft-tissue infection characterized by rapid progression and often fatal outcomes, presents diagnostic challenges owing to nonspecific initial symptoms such as pain, erythema, and edema. This patient presented to the emergency department with fever, arm redness, and blisters after the initial discharge with antibiotics from another facility.
View Article and Find Full Text PDFJ Int Med Res
December 2024
Department of Trauma Surgery and Orthopedics, BG Klinikum Duisburg, University Duisburg-Essen, Germany.
Necrotizing fasciitis (NF) is a rapidly progressing condition with a high mortality rate. The poor prognosis is often due to delayed diagnosis, which is typically made clinically or radiologically. This case report highlights a rare instance of fulminant NF with an atypical presentation-no initial clinical signs and an unusual radiological appearance.
View Article and Find Full Text PDFIndian J Otolaryngol Head Neck Surg
December 2024
Department of ENT, Pondicherry Institute of Medical Sciences, Pondicherry, India.
We report an uncommon odontogenic actinomycotic cervicothoracic Nectrotizing Fasciitis (NF), treated with tracheostomy, immediate surgical debridement and antibiotics. Red flags for early identification, LRINEC scoring for prognostication, surgical debridement with aerobic & anaerobic culture specific antibiotics to improve survival in this life-threatening cervicothoracic NF in a young diabetic is discussed.
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