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A five-year review of necrotising fasciitis in a tertiary referral unit
INTRODUCTION: Necrotising fasciitis is a life-threatening illness that is often difficult to diagnose. Immediate debridement and intravenous antibiotic therapy are required to limit the spread of infection. This five-year audit aimed to review the number and outcomes of all cases of necrotising fasc...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Royal College of Surgeons
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964641/ https://www.ncbi.nlm.nih.gov/pubmed/23317730 http://dx.doi.org/10.1308/003588413X13511609956093 |
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author | Swain, RA Hatcher, JC Azadian, BS Soni, N De Souza, B |
author_facet | Swain, RA Hatcher, JC Azadian, BS Soni, N De Souza, B |
author_sort | Swain, RA |
collection | PubMed |
description | INTRODUCTION: Necrotising fasciitis is a life-threatening illness that is often difficult to diagnose. Immediate debridement and intravenous antibiotic therapy are required to limit the spread of infection. This five-year audit aimed to review the number and outcomes of all cases of necrotising fasciitis admitted to a tertiary referral unit and to assess the validity of the Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) scoring system. METHODS: A retrospective analysis of patient notes over the five-year period from October 2006 to October 2011 was undertaken. The LRINEC score was calculated for each patient to evaluate its usefulness. RESULTS: Overall, 15 patients were diagnosed with necrotising fasciitis. Three patients died. The median age of patients was 51.0 years (range: 34–76 years). There were no obvious predisposing factors in 8 cases but patients had a median of 2.0 co-morbidities. The most common infective agent, present in five patients, was Group A Streptococcus. Other monomicrobial agents included Group G Streptococcus and Klebsiella pneumoniae. Polymicrobial infections were less common than monomicrobial infections and two patients had a polymicrobial infection including methicillin-resistant Staphylococcus aureus. Although the LRINEC scoring system identified 12 of the 15 patients as having a high or intermediate likelihood of necrotising fasciitis, 3 were classified as low likelihood. CONCLUSIONS: This limited case series strongly suggests that the LRINEC system is too insensitive for diagnosis. |
format | Online Article Text |
id | pubmed-3964641 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Royal College of Surgeons |
record_format | MEDLINE/PubMed |
spelling | pubmed-39646412014-07-17 A five-year review of necrotising fasciitis in a tertiary referral unit Swain, RA Hatcher, JC Azadian, BS Soni, N De Souza, B Ann R Coll Surg Engl Surgery in General INTRODUCTION: Necrotising fasciitis is a life-threatening illness that is often difficult to diagnose. Immediate debridement and intravenous antibiotic therapy are required to limit the spread of infection. This five-year audit aimed to review the number and outcomes of all cases of necrotising fasciitis admitted to a tertiary referral unit and to assess the validity of the Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) scoring system. METHODS: A retrospective analysis of patient notes over the five-year period from October 2006 to October 2011 was undertaken. The LRINEC score was calculated for each patient to evaluate its usefulness. RESULTS: Overall, 15 patients were diagnosed with necrotising fasciitis. Three patients died. The median age of patients was 51.0 years (range: 34–76 years). There were no obvious predisposing factors in 8 cases but patients had a median of 2.0 co-morbidities. The most common infective agent, present in five patients, was Group A Streptococcus. Other monomicrobial agents included Group G Streptococcus and Klebsiella pneumoniae. Polymicrobial infections were less common than monomicrobial infections and two patients had a polymicrobial infection including methicillin-resistant Staphylococcus aureus. Although the LRINEC scoring system identified 12 of the 15 patients as having a high or intermediate likelihood of necrotising fasciitis, 3 were classified as low likelihood. CONCLUSIONS: This limited case series strongly suggests that the LRINEC system is too insensitive for diagnosis. Royal College of Surgeons 2013-01 2013-01 /pmc/articles/PMC3964641/ /pubmed/23317730 http://dx.doi.org/10.1308/003588413X13511609956093 Text en Copyright © 2013 Royal College of Surgeons http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Surgery in General Swain, RA Hatcher, JC Azadian, BS Soni, N De Souza, B A five-year review of necrotising fasciitis in a tertiary referral unit |
title | A five-year review of necrotising fasciitis in a tertiary referral unit |
title_full | A five-year review of necrotising fasciitis in a tertiary referral unit |
title_fullStr | A five-year review of necrotising fasciitis in a tertiary referral unit |
title_full_unstemmed | A five-year review of necrotising fasciitis in a tertiary referral unit |
title_short | A five-year review of necrotising fasciitis in a tertiary referral unit |
title_sort | five-year review of necrotising fasciitis in a tertiary referral unit |
topic | Surgery in General |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964641/ https://www.ncbi.nlm.nih.gov/pubmed/23317730 http://dx.doi.org/10.1308/003588413X13511609956093 |
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