AbstractBackground: Necrotizing fasciitis is a rapidly progressing mono/ polymicrobial skin infection that spreads to underlying tissues leading to life threatening situations. Immediate surgical debridement together with i.v antibiotic administration is required to avoid fatal outcome. Early diagnosis is often delayed due to underestimation or confusion with cellulitis. The laboratory risk indicator for necrotizing fasciitis (LRINEC) is useful for early recognition of necrotizing fasciitis.
Objective: To validate the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) scoring system for the diagnosis of necrotizing fasciitis among patients presenting with soft tissue infections.
Materials and Methods: This is a Hospital based Diagnostic Evaluation Study. All patients presenting with soft tissue infections during the period of 18 months (1st September 2015 to 28th February 2017) were included in the study and LRINEC scoring system was applied. Parameters included are Haemoglobin, Total WBC count, Serum Creatinine, Serum Sodium, Random Blood Glucose value and CRP at the time of admission. A score 6 was found to be highly suspicious of Necrotising Fascitis. The confirmatory diagnosis for necrotising fasciitis was done with histopathology.
Results: A total of 112 patients were evaluated during the study period of 18 months. Of this 41 patients had necrotising fasciitis and 71 had Cellulitis. The LRINEC score 6 had a sensitivity of 63.4%, specificity of 73.2%, positive predictive ratio of 57.7% and negative predictive ratio of 77.6%.
Conclusion: The LRINEC score is a very useful diagnostic tool which can be used to distinguish necrotizing fasciitis from soft tissue infections.