Format

Send to

Choose Destination
J Emerg Med. 2013 May;44(5):928-31. doi: 10.1016/j.jemermed.2012.09.039. Epub 2012 Dec 31.

A case of necrotizing fasciitis with a LRINEC score of zero: clinical suspicion should trump scoring systems.

Author information

1
Department of Emergency Medicine, UC San Diego Health System, San Diego, California, USA.

Abstract

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.

PMID:
23287745
DOI:
10.1016/j.jemermed.2012.09.039
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center