Abstract
Background: The LRINEC score (laboratory risk indicators for necrotizing fasciitis) was established in 2004 to aid in the differentiation of necrotizing fasciitis from severe soft tissue infections. Methods: The study included all patients hospitalized to the department of general surgery at Dr. Rajendra Prasad Govt. Medical College & Hospital, Kangra, Tanda, H.P. India with a diagnosis of necrotizing fasciitis for a period of one year, from June 2018 to May 2019. At the time of admission, the patient’s hemoglobin, white blood cell count, C-reactive protein, blood glucose level, urea, sodium, potassium and creatinine levels (LIRNEC Score) were calculated. Results: In all the patients LRINEC Score was > 6. Out of 60 patients, 14(23%) patients had LRINEC Score in between 6 to 7 and 46 (76%) patients had LRINEC score >8. Conclusion: The LRINEC score of 6 and above suggest NF and therefore aiding in the early recognition of NSTI and its management.
Highlights
Necrotizing fasciitis (NF) is a severe and sometimes fatal soft tissue infection that spreads quickly along fascial planes
The study included all patients hospitalized to the department of general surgery at Dr Rajendra Prasad Govt
Out of 60 patients, 14(23%) patients had LRINEC Score in between 6 to 7 and 46 (76%) patients had LRINEC score >8
Summary
Necrotizing fasciitis (NF) is a severe and sometimes fatal soft tissue infection that spreads quickly along fascial planes. This fast spread frequently results in hemodynamic instability and systemic sepsis, which can progress to multiple organ failure and death. The frequent presenting symptoms of swelling, pain, and erythema [1] are non-specific, and early necrotizing fasciitis can be confused with cellulitis [2], which is generally managed non-operatively. There are more specific "hard symptoms" of necrotizing fasciitis, including exaggerated pain, quickly spreading infection, bullae, skin ecchymosis/sloughing, gas in tissue, skin anaesthesia, edoema other than erythema, and sepsis, they are present in only 43% of cases [3]
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