Gangrene laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Edzel Lorraine Co, D.M.D., M.D.
Overview
Evaluation of patients with ischemic gangrene is more focused on targeting the risk factors which include hyperlipidemia, diabetes, and renal failure. Laboratory tests to deal with these risk factors are usually requested for ischemic gangrene. Wet gangrene and gas gangrene are assessed with the help of cultures.[1] [2]
Laboratory Findings
- Patients with gangrene often have a non-specic laboratory findings.
- Table 1 lists the commonly requested laboratories with the usual laboratory findings in a patient with gangrene.
| Laboratory Test | Findings [3] [4] [5] [6] [7] [8] |
|---|---|
| Complete Blood Count | Leukocytosis with left shift, and coagulopathy]. |
| Serum Electrolytes | Hyponatremia |
| C-Reactive Protein (CRP) | Elevated CRP level. |
| Erythrocyte Sedimentation Rate (ESR) | Elevated ESR level. |
| Liver Function Tests | Elevated Alanine aminotransferase (ALT, and Aspartate aminotransferase (AST) levels. |
| Creatine Kinase (CK) | Elevated CK level. |
| Lactate | Elevated lactate level. |
- Evaluation of patients with ischemic gangrene is more focused on targeting the risk factors which include hyperlipidemia, diabetes, and renal failure.
- Laboratory tests to deal with these risk factors are usually requested for ischemic gangrene.
- Wet gangrene and gas gangrene are assessed with the help of cultures.[1] [2] [9]
- Table 2 summarizes the types of gangrene and the laboratory tests needed for each type.
| Type of Gangrene | Laboratory Tests Needed |
|---|---|
| Wet Gangrene | Gram Stain, wound culture |
| Gas Gangrene | Gram Stain, wound culture |
- The following are the common microorganisms found in the culture of wound specimens with gangrene.
- Clostridium perfringens
- Clostridium sordellii
- Clostridium septicum
References
- ↑ 1.0 1.1 Elsayed S, Clavijo LC (2015). "Critical limb ischemia". Cardiol Clin. 33 (1): 37–47. doi:10.1016/j.ccl.2014.09.008. PMID 25439329.
- ↑ 2.0 2.1 Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R; et al. (2019). "Global vascular guidelines on the management of chronic limb-threatening ischemia". J Vasc Surg. 69 (6S): 3S–125S.e40. doi:10.1016/j.jvs.2019.02.016. PMC 8365864 Check
|pmc=value (help). PMID 31159978. - ↑ Stevens DL, Bryant AE (2017). "Necrotizing Soft-Tissue Infections". N Engl J Med. 377 (23): 2253–2265. doi:10.1056/NEJMra1600673. PMID 29211672.
- ↑ Stevens DL, Tanner MH, Winship J, Swarts R, Ries KM, Schlievert PM; et al. (1989). "Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A." N Engl J Med. 321 (1): 1–7. doi:10.1056/NEJM198907063210101. PMID 2659990.
- ↑ Simonart T, Simonart JM, Derdelinckx I, De Dobbeleer G, Verleysen A, Verraes S; et al. (2001). "Value of standard laboratory tests for the early recognition of group A beta-hemolytic streptococcal necrotizing fasciitis". Clin Infect Dis. 32 (1): E9–12. doi:10.1086/317525. PMID 11202110.
- ↑ Yaghoubian A, de Virgilio C, Dauphine C, Lewis RJ, Lin M (2007). "Use of admission serum lactate and sodium levels to predict mortality in necrotizing soft-tissue infections". Arch Surg. 142 (9): 840–6, discussion 844-6. doi:10.1001/archsurg.142.9.840. PMID 17875838.
- ↑ Butterworth SA, Murphy JJ (2006). "Necrotizing soft tissue infections--are they different in healthy vs immunocompromised children?". J Pediatr Surg. 41 (5): 935–9. doi:10.1016/j.jpedsurg.2006.01.012. PMID 16677887.
- ↑ Wall DB, Klein SR, Black S, de Virgilio C (2000). "A simple model to help distinguish necrotizing fasciitis from nonnecrotizing soft tissue infection". J Am Coll Surg. 191 (3): 227–31. doi:10.1016/s1072-7515(00)00318-5. PMID 10989895.
- ↑ Yoder EL, Mendez J, Khatib R (1987). "Spontaneous gangrenous myositis induced by Streptococcus pyogenes: case report and review of the literature". Rev Infect Dis. 9 (2): 382–5. doi:10.1093/clinids/9.2.382. PMID 3296102.