Use of Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score in differentiating Necrotising Fasciitis cases from Soft tissue infections: A Prospective Study

2018 ◽  
Vol 4 (3) ◽  
Author(s):  
Ragya Bharadwaj ◽  
Adil Mahmud Ali ◽  
Nafis Ahmad Faruqi
Keyword(s):  
Soft Tissue ◽  
Prospective Study ◽  
Necrotizing Fasciitis ◽  
Necrotising Fasciitis ◽  
Risk Indicator ◽  
Soft Tissue Infections ◽  
Lrinec Score ◽  
A Prospective Study

scholarly journals Laboratory risk indicator for necrotising fasciitis [LRINEC] score as a tool for differentiating necrotising fasciitis from other soft tissue infections

2021 ◽  
Vol 38 (4) ◽  
pp. 571-576
Author(s):  
Raghunatha REDDY ◽  
Purushothaman RANGASWAMY ◽  
Preetham RAJ ◽  
Chandrakant KESARI ◽  
Ganesh SAGAR
Keyword(s):  
High Risk ◽  
Soft Tissue ◽  
High Risk Group ◽  
Necrotising Fasciitis ◽  
Risk Indicator ◽  
Soft Tissue Infections ◽  
College Hospital ◽  
Medical College ◽  
Lrinec Score ◽  
Severe Soft Tissue

Necrotizing fasciitis (NF) is often fatal, characterized by extensive necrosis of the subcutaneous tissues and fascia. The present study was aimed to validate the Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) score as a tool to predict/diagnose NF and to differentiate it from other soft tissue infections depending on the score. A Prospective Observational study was conducted in ESICMC PGI MSR, Medical College Hospital, Rajajinagar, Bengaluru, from Jan 2019 to June 2020. Patients ≥18 years of age with severe soft tissue infections were included in the study. Based on the LRINEC score, the patients were categorised as low (≤5), moderate (6-7) and high risk (≥8) for the prediction of onset or diagnosis of NF. Data analysis was performed using SPSS version 21.0. A total of 55 patients were included in the study. A significant 3 association was observed Dweitpharatgmee(npt=o0f.0X4X2)X, ,LURnINivEerCsitsycorfeX(pX=X0,.0X0X01X),TCraRineiancgtiavnedPRroetseianrc(hCRHPo;spi=ta0l.,0C00it1y),,Choauenmtroyglobin (p=0.008), serum 4 sodium levels (p=0.004), serum creatinine (0.D00e1p)a,ratmndenatmopfuXtaXtiXon, F(pac=u0l.t0y0o4f).XAXmXp,uCtaityio,nCwouanstdryone in 5 cases. Only 1 mortality was observed in LRINEC high risk group with NSSTI. To conclude, LRINEC scoring system showed a better positive predictive value in identifying the onset of NF and risk strategizing of the patients with severe soft tissue infections.

scholarly journals Study of the effectiveness of laboratory risk indicator for necrotizing fasciitis scoring system in the diagnosis of necrotizing fasciitis among patients presenting with soft tissue infections

2021 ◽  
Vol 8 (7) ◽  
pp. 2041
Author(s):  
Shreeniketan Nayak ◽  
Prakash S. Kattimani
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Soft Tissue Infection ◽  
Scoring System ◽  
Tissue Infection ◽  
Risk Indicator ◽  
Soft Tissue Infections ◽  
Predictive Values ◽  
Necrotizing Soft Tissue Infection ◽  
Lrinec Score

Background: Necrotizing soft tissue infection (NSTI) is an uncommon but life threatening disease with a high mortality rate. Delay in diagnoses and in surgery for debridement is associated with increased mortality rates. Hence here we would like to use this scoring system - laboratory risk indicator for necrotizing fasciitis (LRINEC) in patients presenting to our hospital with necrotizing soft tissue infection and if found to have good predictive values, it would be a boon to developing countries like India where the mortality of the disease is high (7% to 76%).Methods: Patients presenting with symptoms suggestive of soft tissue infection underwent clinical examination and basic laboratory investigations. Following which, information collected using semi structured proforma cum observational checklist. LRINEC scoring system applied to each of the study subjects at admission. The confirmatory diagnosis of necrotizing fasciitis done on patients who undergo surgery vide histopathology, irrespective of the result of the LRINEC scoring system. Tissue cultures and sensitivity patterns analyzed.Results: A total of 100 patients were enrolled. LRINEC score has an ability to diagnose necrotizing fasciitis from other soft tissue infections. High LRINEC score had more incidences of features of sepsis. Presence of the co morbidities tended to increase the LRINEC score. And defines patients with a high LRINEC score of >8 had higher mortality rate.Conclusions: LRINEC score is a simple clinical tool for the diagnosis of necrotizing fasciitis from other soft tissue infections. LRINEC scoring system and clinical assessment should be used concurrently for diagnosing necrotizing fasciitis from other soft tissue infections.

scholarly journals A PROSPECTIVE STUDY TO ASSESS THE DIAGNOSTIC EFFICACY OF LABORATORY RISK INDICATOR FOR NECROTIZING FASCIITIS (LRINEC) SCORING SYSTEM IN PATIENTS WITH SOFT TISSUE INFECTION

2020 ◽  
pp. 37-39
Author(s):  
K. Vani ◽  
Gattupalli Bhaswanth Kumar Reddy ◽  
B. Jayakiran ◽  
J. Ramanaiah ◽  
B. Balaji ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Prospective Study ◽  
Necrotizing Fasciitis ◽  
Soft Tissue Infection ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Tissue Infection ◽  
Risk Indicator ◽  
Care Hospital ◽  
A Prospective Study

Background Necrotizing fasciitis which is commonly known as “Flesh-Eating Disease” is an uncommon soft-tissue infection. It is characterized by widespread fascial necrosis with relative sparing of overlying skin and underlying muscle. Mostly it is associated with severe systemic toxicity and a fulminant course. It is usually rapidly fatal unless promptly recognized and aggressively treated with appropriate antimicrobials and surgical debridement at the earliest. Methods Our study was a prospective study conducted on 140 patients over a period of 2 years from June 2018 to June 2020 in a tertiary care hospital, GGH, Kadapa. All patients were selected randomly and evaluated by taking proper history, thorough clinical examination, routine laboratory investigations and histopathological examination of the debrided tissue and the outcomes were analysed to know the efficacy of LRINEC Scoring in diagonising necrotizing fasciitis. Results Most common age group was 41-50 years. Males were commonly affected, accounting to 74% i.e., 111 patients and the remaining 39 patients were females (39%). Fever, inflammation of the involved area were the most common presentations. Majority were diabetic and hypertensive accounting to 55.3% and 52.7% respectively. All patients presented with symptoms with swelling, redness, pain and induration. Eighty-one percent had elevated CRP. Total WBC count was raised in 78.7% of the cases. Fifty-six percent of the cases had haemoglobin less than 11g/dl. Hyponatremia was observed in 81.3% of the patients. Majority (52.7%) had normal sr. creatinine i.e., < or =1.4. RBS was elevated in 54.7% of the cases. In our study 87.3% of the patients had a LRINEC score >6. Histology was positive for necrotising fasciitis in 92% of the cases, among them majority had polymicrobial organisms on culture. Conclusion In patients with severe soft tissue infections, LRINEC scoring based on laboratory parameters is an easy and reliable diagnostic tool to diagnose Necrotizing fasciitis accurately.

scholarly journals Hospital admissions for skin and soft tissue infections in a population with endemic scabies: A prospective study in Fiji, 2018–2019

2020 ◽  
Vol 14 (12) ◽  
pp. e0008887
Author(s):  
Li Jun Thean ◽  
Adam Jenney ◽  
Daniel Engelman ◽  
Lucia Romani ◽  
Handan Wand ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Prospective Study ◽  
Indigenous Population ◽  
Hospital Admissions ◽  
Case Fatality ◽  
Soft Tissue Infections ◽  
Predisposing Factor ◽  
A Prospective Study ◽  
Crusted Scabies ◽  
Very High

Scabies is an important predisposing factor for impetigo but its role in more serious skin and soft tissue infections (SSTIs) is not well understood. Information is limited on incidence of SSTIs in the presence of endemic scabies. We conducted a prospective study of hospital admissions for SSTIs in the Northern Division of Fiji (population: 131,914). Prospective surveillance for admissions with impetigo, abscess, cellulitis, wound infection, pyomyositis, necrotizing fasciitis, infected scabies, and crusted scabies was conducted at the Division’s referral hospital between 2018 to 2019. Information was collected on demographic characteristics, clinical features, microbiology, treatment and outcomes. Over the study period, 788 SSTI admissions were recorded corresponding to a population incidence 647 per 100,000 person-years (95%CI 571–660). Incidence was highest at the extremes of age with peak incidence in children aged <5 years (908 per 100,000) and those aged ≥65 years (1127 per 100,000). Incidence was 1.7 times higher among the Indigenous Fijian population (753 per 100,000) compared to other ethnicities (442 per 100,000). Overall case fatality rate was 3.3%, and 10.8% for those aged ≥65 years. Scabies was diagnosed concurrently in 7.6% of all patients and in 24.6% of admitted children <5 years. There is a very high burden of hospital admissions for SSTIs in Fiji compared to high-income settings especially among the youngest, oldest and indigenous population which is concordant with scabies and impetigo distribution in this population. Our findings highlight the need for strategies to reduce the burden of SSTIs in Fiji and similar settings.

scholarly journals Necrotizing Soft-Tissue Infection: Laboratory Risk Indicator for Necrotizing Soft Tissue Infections Score

2014 ◽  
Vol 6 (01) ◽  
pp. 046-049 ◽  
Author(s):  
Madhuri Kulkarni ◽  
Vijay Kumar GS ◽  
Sowmya GS ◽  
Madhu CP ◽  
Ramya SR
Keyword(s):  
Soft Tissue ◽  
Immunocompromised Host ◽  
High Morbidity ◽  
Risk Indicator ◽  
Soft Tissue Infections ◽  
Acinetobacter Species ◽  
Mortality And Morbidity ◽  
Necrotizing Soft Tissue Infections ◽  
Lrinec Score ◽  
Immunocompromised Hosts

ABSTRACTNecrotizing soft tissue infections (NSTI) can be rapidly progressive and polymicrobial in etiology. Establishing the element of necrotizing infection poses a clinical challenge. A 64-year-old diabetic patient presented to our hospital with a gangrenous patch on anterior abdominal wall, which progressed to an extensive necrotizing lesion within 1 week. Successive laboratory risk indicator for necrotizing softtissue infections (LRINEC) scores confirmed the necrotizing element. Cultures yielded Enterococci, Acinetobacter species and Apophysomyces elegans and the latter being considered as an emerging agent of Zygomycosis in immunocompromised hosts. Patient was managed with antibiotics, antifungal treatment and surgical debridement despite which he succumbed to the infection. NSTI’s require an early and aggressive management and LRINEC score can be applied to establish the element of necrotizing pathology. Isolation of multiple organisms becomes confusing to establish the etiological role. Apophysomyces elegans, which was isolated in our patient is being increasingly reported in cases of necrotizing infections and may be responsible for high morbidity and mortality. This scoring has been proposed as an adjunct tool to Microbiological diagnosis when NSTI’s need to be diagnosed early and managed promptly to decrease mortality and morbidity, which however may not come in handy in an immunocompromised host with polymicrobial aggressive infection.

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