Fournier gangrene laboratory tests
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Steven C. Campbell, M.D., Ph.D.; Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[1]; Jesus Rosario Hernandez, M.D. [2]
Overview
The most important laboratory findings in necrotizing fasciitis include C-reactive protein, total white blood cell count, Hemoglobin, Sodium, Creatinine, Glucose. The main importance of these laboratory findings are due to their usage as a distinguishing method for differentiating necrotizing fasciitis from other soft tissue infections.
Laboratory Findings
The most important laboratory findings in necrotizing fasciitis include C-reactive protein, total white blood cell count, Hemoglobin, Sodium, Creatinine, Glucose. The main importance of these laboratory findings are due to their usage as a distinguishing method for differentiating necrotizing fasciitis from other soft tissue infections. Laboratory findings consistent with the diagnosis of Fournier gangrene include:
- CBC with differential count
- Culture of open wound or abscess
- Disseminated intravascular coagulation panel
- Coagulation studies(PT, aPTT, thrombin time etc)
- Fibrinogen/fibrin degradation product levels
- Blood culture
- Urine culture
- Arterial blood gas analysis
- Electrolyte panel
- Blood urea nitrogen (BUN)
- Creatinine
- Blood glucose levels
Laboratory risk indicator for necrotizing fasciitis (LRINEC) scoring system
LRINEC is a diagnostic scoring system used to distinguish necrotizing fasciitis from other soft tissue infections.[1][2] It was first established by Wong et al in 2004.
| Variable | Score | ||||
|---|---|---|---|---|---|
| 0 | +1 | +2 | +3 | +4 | |
| C-reactive protein (mg/dL) | <150 | >150 | |||
| Total White Blood Cell Count (/mm3) | <15 | 15-25 | >25 | ||
| Hemoglobin (g/dL) | <13.5 | 11-13.5 | <11 | ||
| Sodium (mmol/L) | ≥135 | <135 | |||
| Creatinine (μmol/L) | <141 | >141 | |||
| Glucose (mmol/L) | <10 | >10 | |||
- Score of ≤5 indicates low risk
- Score of 6-7 indicates intermediate risk
- Score of ≥8 indicates high risk
References
- ↑ Wong CH, Khin LW, Heng KS, Tan KC, Low CO (2004). "The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections". Crit Care Med. 32 (7): 1535–41. PMID 15241098.
- ↑ Mallikarjuna MN, Vijayakumar A, Patil VS, Shivswamy BS (2012). "Fournier's Gangrene: Current Practices". ISRN Surg. 2012: 942437. doi:10.5402/2012/942437. PMC 3518952. PMID 23251819.