Necrotizing fasciitis laboratory findings
|
Necrotizing fasciitis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Necrotizing fasciitis laboratory findings On the Web |
|
American Roentgen Ray Society Images of Necrotizing fasciitis laboratory findings |
|
Risk calculators and risk factors for Necrotizing fasciitis laboratory findings |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]
Overview
Laboratory Findings
Laboratory tests consistent with diagnosis of necrotizing fasciitis include:
Microbiology
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)
Hematology
The following are complete blood count with differential findings:
- Rapidly falling heamoglobin
- Leucocytosis (>14,000/µL)
- Leucopenia (if associated with STSS)
- Lymphopenia
- Thrombocytopenia
Boichemistry
The biochemistry findings consistent with diagnosis of necrotizing fasciitis include:
- Elevated C-reactive protein
- Elevated serum creatinine kinase
- Hypocalcemia (sign of severity in synergistic NF)
- Hypoalbuminemia
- Hyponatremia (<135mmol/L)
- Elevated serum lactate levels (high serum lactate combined with low sodium levels may be predictive of mortality)
- Arterial blood gas analysis
- Urine analysis
- Elevated Blood urea nitrogen (BUN)
Biopsy
- Deep incisional biopsy (include advancing edge and central necrotic areas)
Laboratory risk indicator for necrotizing fasciitis (LRINEC) scoring system
- LRINEC is a diagnostic scoring system used to distinguish necrotizing fasciitis from other soft tissue infections.[1]
- It was first established by by Wong et al in 2004.
- Risk assessment of necrotizing faciitis using LRINEC score:
- Low risk: ≤5
- Intermediate risk: 6-7
- High risk: ≥8
References
- ↑ Wong CH, Khin LW, Heng KS, Tan KC, Low CO (2004). "The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections". Crit Care Med. 32 (7): 1535–41. PMID 15241098.