A STUDY TO ASSESS THE LEVEL OF SUSPICION OF NECROTIZING FASCIITIS IN PATIENTS WITH CELLULITIS OF LOWER LIMB USING MODIFIED LRINEC SCORE IN A TERTIARY CENTRE IN KERALA

Abstract

Background: Cellulitis is a spreading inammation of the subcutaneous and fascial tissues, characterized by erythema, swelling, warmth, and pain. Necrotizing fasciitis is a rare but rapidly progressive devastating soft tissue necrosis that usually involves fascia and subcutaneous tissues with a signicant hospital morbidity and mortality. Necrotizing fasciitis is a differential diagnosis of extensive cellulitis but a highly fatal condition. If we are able to clinically asses the patient at the time of presentation along with the laboratory parameters risk stratication can be done. Aims and Objectives: This study assesses the level of suspicion of Necrotizing fasciitis in patients with cellulitis of the lower limb using Modied LRINEC score. The study was a cross sectional study involving 787 patients conducted in the department of Materials & Methods: General Surgery of Dr.Somervell Memorial CSI Medical College, Karakonam,Trivandrum during a period of 18 months. All the patients clinically diagnosed as cellulitis of lower limb were the study subjects and routine investigations were done. In the present study 787 patients who presented with Results: lower limb cellulitis were included and modied LRINEC Score was calculated. The average modied LRINEC score was 3.5122. Out of 433 patients with random blood sugar value of more than 180mg/dL, in only 0.7% of patients and out of 399 patients with a history of trauma, in only 5.3% of patients, there was a strong suspicion of necrotizing fasciitis. In patie Conclusion: nts presenting with cellulitis, there is a high chance of progression of the disease to involve the deep fascia and result in necrotizing soft tissue infections. Modied Laboratory Risk Indicators for Necrotizing Fasciitis (M-LRINEC) score helps in risk stratication of the patient.