Document Detail


A Case of Necrotizing Fasciitis with a LRINEC Score of Zero: Clinical Suspicion Should Trump Scoring Systems.
MedLine Citation:
PMID:  23287745     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Necrotizing fasciitis (NF) is a potentially lethal infection involving the skin, subcutaneous tissue, and fascia. The Laboratory Risk Indicator for Necrotizing fasciitis (LRINEC) score has been proposed as a way of using abnormal laboratory values to distinguish between severe cellulitis and necrotizing fasciitis. OBJECTIVES: The utility of the LRINEC system, including a review of current literature on this scoring system, is discussed. CASE REPORT: A case of a 37-year-old man is presented. As part of the diagnostic work-up, appropriate laboratory tests necessary to calculate a LRINEC score were obtained. Despite a LRINEC score of 0, NF was later confirmed at surgery. CONCLUSIONS: Although the LRINEC score has been proposed as a robust way of identifying patients with early NF, it failed to detect NF in the patient reported here. NF should thus remain primarily a disease of clinical suspicion, and this suspicion should trump the LRINEC score.
Authors:
Michael P Wilson; Aaron B Schneir
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-31
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  -     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2013-1-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
Affiliation:
Department of Emergency Medicine, UC San Diego Health System, San Diego, California.
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