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Am J Surg. 2000 Jan;179(1):17-21.

Objective criteria may assist in distinguishing necrotizing fasciitis from nonnecrotizing soft tissue infection.

Author information

1
Department of Surgery, Harbor-University of California Los Angeles Medical Center, Torrance 90509, USA.

Abstract

BACKGROUND:

Optimal treatment of necrotizing fasciitis (NF) requires rapid diagnosis. The purpose of the study was to identify objective admission measurements that help differentiate NF from nonnecrotizing (non-NF) infection and, among NF patients, to identify admission factors that predict mortality.

METHODS:

Twenty-one NF cases were paired with matched non-NF controls. Statistical comparison of admission vital signs, laboratory values, and radiographic studies was performed.

RESULTS:

On multivariate analysis, admission white blood cell count (WBC) >14 x 10(9)/L, serum sodium <135 mmol/L, and blood urea nitrogen (BUN) >15 mg/dL separated NF from non-NF patients. Mortality for NF patients was predicted by admission WBC >30 x 10(9)/L. Mortality was also significantly increased for patients transferred from an outside institution prior to definitive therapy.

CONCLUSIONS:

Objective admission criteria (elevated WBC and BUN and decreased serum sodium) can assist in distinguishing NF from non-NF infections. The best objective predictor of mortality in NF patients is marked elevation of admission WBC.

PMID:
10737571
[Indexed for MEDLINE]

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