Necrotizing fasciitis laboratory findings
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Laboratory tests consistent with diagnosis of necrotizing fasciitis include:
The following are the tests used to diagnose the causative organism:
- Gram stain and culture of tissues and aspirates
- Blood culture
- Culture of throat and vaginal swabs
- Fungal culture (immunocompromised or trauma patients)
- Enrichment cultures (patients with recent antibiotic use)
The biochemistry findings consistent with diagnosis of necrotizing fasciitis include:
- Elevated C-reactive protein
- Elevated serum creatine kinase
- Hypocalcemia (sign of severity in synergistic NF)
- Hyponatremia (<135mmol/L)
- Elevated serum lactate levels (high serum lactate combined with low sodium levels may be predictive of mortality)
- Arterial blood gas (ABG) analysis
- Urine analysis
- Elevated blood urea nitrogen (BUN)
The following are complete blood count with differential findings:
Tissue oxygen saturation
Other diagnostic studies of necrotizing fasciitis include:
- Tissue oxygen saturation monitoring:
- Occurs at the bedside.
- Is a noninvasive method to continuously monitor extremities at risk and avoid delayed diagnosis
- Tissue oxygen saturation is measured using near-infrared spectroscopy.
- In patients with necrotizing faciitis, oxygen saturation are often diminished in the lower extremities and return to normal after fasciotomy.
- Puvanendran R, Huey JC, Pasupathy S (2009). "Necrotizing fasciitis". Can Fam Physician. 55 (10): 981–7. PMC 2762295. PMID 19826154.
- Wang TL, Hung CR (2004). "Role of tissue oxygen saturation monitoring in diagnosing necrotizing fasciitis of the lower limbs". Ann Emerg Med. 44 (3): 222–8. doi:10.1016/S0196064404003038. PMID 15332062.