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 Differentiating necrotizing soft tissue infections from cellulitis by soft tissue infectious fluid analysis: a pilot study

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Kai-Hsiang Wu ◽  
Po-Han Wu ◽  
Chih-Yao Chang ◽  
Yen-Ting Kuo ◽  
Kuang-Yu Hsiao ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Diagnostic Accuracy ◽  
Soft Tissue Infection ◽  
Tertiary Care ◽  
Tissue Infection ◽  
Test Method ◽  
Deep Fascia ◽  
Pathology Report ◽  
Care Hospital ◽  
Gram Stain

Abstract Background We conducted this study to evaluate the characteristics of the infectious fluid in soft tissue infection and investigate the utility of the biochemical tests and Gram stain smear of the infectious fluid in distinguishing necrotizing soft tissue infection (NSTI) from cellulitis. Methods This retrospective cohort study was conducted in a tertiary care hospital in Taiwan. From April 2019 to October 2020, patients who were clinically suspected of NSTI with infectious fluid accumulation along the deep fascia and received successful ultrasound-guided aspiration were enrolled. Based on the final discharge diagnosis, the patients were divided into NSTI group, which was supported by the surgical pathology report, or cellulitis group. The t test method and Fisher’s exact test were used to compare the difference between two groups. The receiver–operator characteristic (ROC) curves and area under the ROC curve (AUC) were used to evaluate the discriminating ability. Results Total twenty-five patients were enrolled, with 13 patients in NSTI group and 12 patients in cellulitis group. The statistical analysis showed lactate in fluid (AUC = 0.937) and LDH in fluid (AUC = 0.929) had outstanding discrimination. The optimal cut-off value of fluid in lactate was 69.6 mg/dL with corresponding sensitivity of 100% and specificity of 76.9%. The optimal cut-off value of fluid in LDH was 566 U/L with corresponding sensitivity of 83.3% and a specificity of 92.3%. In addition, albumin in fluid (AUC = 0.821), TP in fluid (AUC = 0.878) and pH in fluid (AUC = 0.858) also had excellent diagnostic accuracy for NSTI. The Gram stain smear revealed 50% bacteria present in NSTI group and all the following infectious fluid culture showed bacteria growth. Conclusions The analysis of infectious fluid along the deep fascia might provide high diagnostic accuracy to differentiate NSTI from cellulitis.

scholarly journals Enigma in the diagnosis of congenital neck masses: a prospective study

2019 ◽  
Vol 6 (1) ◽  
pp. 159
Author(s):  
Rajesh Radhakrishna Havaldar ◽  
Anju Singh ◽  
Priti S. Hajare ◽  
Shama A. Bellad ◽  
R. S. Mudhol
Keyword(s):  
Prospective Study ◽  
Bronchogenic Cyst ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Needle Aspiration ◽  
Neck Mass ◽  
Care Hospital ◽  
Duct Cyst ◽  
Neck Masses ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> Head and neck swellings are common in routine otorhinolaryngologic practice. This study was done to assess the incidence and varied presentation of different congenital neck swellings.</p><p class="abstract"><strong>Methods:</strong> Hospital based prospective study done in the Department of Otorhinolaryngology at a tertiary care hospital from January 2017 to December 2018. A total of 28 patients with slow, progressive neck swellings were selected after excluding thyroid swellings and acute inflammatory neck swellings. All patients had no other complaints. After a thorough clinical examination and investigations like ultrasonography, fine needle aspiration cytology and radiological examination, surgery was done, and specimens obtained were sent for histopathological examination. Patients were followed up to 1 year.  </p><p class="abstract"><strong>Results:</strong> 28 patients with congenital neck mass were studied. 15 were thyroglossal cysts, 7 were branchial anomalies, 5 were dermoid cysts and 1 was bronchogenic cyst. The most frequent congenital neck mass was thyroglossal duct cyst and fistula (53.57%) followed by, in descending order, cysts and fistulas of the branchial apparatus (25%), dermoid cysts (17.85%) and bronchogenic cyst (3.5%) respectively.</p><p class="abstract"><strong>Conclusions:</strong> The overall presentation in terms of age group, location, incidence and clinical features of congenital neck swellings is an enigma to the treating surgeon as well as the pathologist. The prevalence varies largely among centres. A knowledge of the varied differential diagnosis of slow progressive masses in the neck should be kept in mind while planning the surgical procedure for total removal of the lesion to avoid recurrence.</p>

scholarly journals The association between laboratory risk indicator for necrotizing fasciitis score with clinical signs and symptoms of necrotizing fasciitis: a retrospective study

2021 ◽  
Vol 8 (5) ◽  
pp. 1532
Author(s):  
Ajay Chauhan ◽  
Yashashvi Patel ◽  
Amit S. Chauhan ◽  
Fateh S. Mehta
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Soft Tissue Infection ◽  
Randomized Study ◽  
Clinical Signs ◽  
Tissue Infection ◽  
Anatomical Location ◽  
Risk Indicator ◽  
Good Tool ◽  
Lrinec Score

Background: The term necrotizing soft tissue infection encompassing simple pyoderma to life threatening infection, varying with regards to anatomical location, tissue involvement and offending organism. Early diagnosis of necrotizing-STI is important for timely surgical intervention, but physical findings can vary, so misdiagnosis is common. By using WBC, CRP, haemoglobin, Na, creatinine, glucose and clinical examination we can distinguish NF from other STI.Methods: This was a retrospective and randomized study in the Geetanjali Medical College and Hospital affiliated to Geetanjali University from January 2017 to January 2019 during this period total 66 patients with soft tissue Infection were admitted and included. Clinical details and investigations were recorded from the case sheet and were analyzed with WBC, CRP, Hb, Na, creatinine and glucose.Results: The most commonly affected age group was 46-60 years with male preponderance. Most common cause of STI was Trauma 66.66% of the patients having Primary Site Lower Limb in 12.12%  and as per LRINEC score 50% of the patients have low risk, 37.87% of the patients have high risk and strongly in favour of NF and 12.12% of the patients have intermediate risk.Conclusions: The LRINEC score is a good tool for NF risk stratification and patients are advised to be careful for presence of NF if LRINEC score is≥6.

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