Gangrene laboratory findings: Difference between revisions

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Latest revision as of 17:46, 14 July 2022

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Edzel Lorraine Co, D.M.D., M.D.

Overview

Evaluation of patients with ischemic gangrene is more focused on targeting the risk factors which include hyperlipidemia, diabetes, and renal failure. Laboratory tests to deal with these risk factors are usually requested for ischemic gangrene. Wet gangrene and gas gangrene are assessed with the help of cultures.^[1] ^[2]

Laboratory Findings

Patients with gangrene often have a non-specic laboratory findings.
Table 1 lists the commonly requested laboratories with the usual laboratory findings in a patient with gangrene.

**Table 1. Laboratory Tests Commonly Done to Diagnose Gangrene.**
Laboratory Test	Findings ^[3] ^[4] ^[5] ^[6] ^[7] ^[8]

Complete Blood Count	Leukocytosis with left shift, and coagulopathy].
Serum Electrolytes	Hyponatremia
C-Reactive Protein (CRP)	Elevated CRP level.
Erythrocyte Sedimentation Rate (ESR)	Elevated ESR level.
Liver Function Tests	Elevated Alanine aminotransferase (ALT, and Aspartate aminotransferase (AST) levels.
Creatine Kinase (CK)	Elevated CK level.
Lactate	Elevated lactate level.

Evaluation of patients with ischemic gangrene is more focused on targeting the risk factors which include hyperlipidemia, diabetes, and renal failure.
Laboratory tests to deal with these risk factors are usually requested for ischemic gangrene.
Wet gangrene and gas gangrene are assessed with the help of cultures.^[1] ^[2] ^[9]
Table 2 summarizes the types of gangrene and the laboratory tests needed for each type.

**Table 2. Types of Gangrene and their Respective Laboratory Tests.**
Type of Gangrene	Laboratory Tests Needed

Wet Gangrene	Gram Stain, wound culture
Gas Gangrene	Gram Stain, wound culture

The following are the common microorganisms found in the culture of wound specimens with gangrene.
- Clostridium perfringens
- Clostridium sordellii
- Clostridium septicum

References

↑ ^1.0 ^1.1 Elsayed S, Clavijo LC (2015). "Critical limb ischemia". Cardiol Clin. 33 (1): 37–47. doi:10.1016/j.ccl.2014.09.008. PMID 25439329.
↑ ^2.0 ^2.1 Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R; et al. (2019). "Global vascular guidelines on the management of chronic limb-threatening ischemia". J Vasc Surg. 69 (6S): 3S–125S.e40. doi:10.1016/j.jvs.2019.02.016. PMC 8365864 Check |pmc= value (help). PMID 31159978.
↑ Stevens DL, Bryant AE (2017). "Necrotizing Soft-Tissue Infections". N Engl J Med. 377 (23): 2253–2265. doi:10.1056/NEJMra1600673. PMID 29211672.
↑ Stevens DL, Tanner MH, Winship J, Swarts R, Ries KM, Schlievert PM; et al. (1989). "Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A." N Engl J Med. 321 (1): 1–7. doi:10.1056/NEJM198907063210101. PMID 2659990.
↑ Simonart T, Simonart JM, Derdelinckx I, De Dobbeleer G, Verleysen A, Verraes S; et al. (2001). "Value of standard laboratory tests for the early recognition of group A beta-hemolytic streptococcal necrotizing fasciitis". Clin Infect Dis. 32 (1): E9–12. doi:10.1086/317525. PMID 11202110.
↑ Yaghoubian A, de Virgilio C, Dauphine C, Lewis RJ, Lin M (2007). "Use of admission serum lactate and sodium levels to predict mortality in necrotizing soft-tissue infections". Arch Surg. 142 (9): 840–6, discussion 844-6. doi:10.1001/archsurg.142.9.840. PMID 17875838.
↑ Butterworth SA, Murphy JJ (2006). "Necrotizing soft tissue infections--are they different in healthy vs immunocompromised children?". J Pediatr Surg. 41 (5): 935–9. doi:10.1016/j.jpedsurg.2006.01.012. PMID 16677887.
↑ Wall DB, Klein SR, Black S, de Virgilio C (2000). "A simple model to help distinguish necrotizing fasciitis from nonnecrotizing soft tissue infection". J Am Coll Surg. 191 (3): 227–31. doi:10.1016/s1072-7515(00)00318-5. PMID 10989895.
↑ Yoder EL, Mendez J, Khatib R (1987). "Spontaneous gangrenous myositis induced by Streptococcus pyogenes: case report and review of the literature". Rev Infect Dis. 9 (2): 382–5. doi:10.1093/clinids/9.2.382. PMID 3296102.

[pmid25439329-1] 1.0 ^1.1 Elsayed S, Clavijo LC (2015). "Critical limb ischemia". Cardiol Clin. 33 (1): 37–47. doi:10.1016/j.ccl.2014.09.008. PMID 25439329.

[pmid31159978-2] 2.0 ^2.1 Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R; et al. (2019). "Global vascular guidelines on the management of chronic limb-threatening ischemia". J Vasc Surg. 69 (6S): 3S–125S.e40. doi:10.1016/j.jvs.2019.02.016. PMC 8365864 Check |pmc= value (help). PMID 31159978.

[pmid29211672-3] Stevens DL, Bryant AE (2017). "Necrotizing Soft-Tissue Infections". N Engl J Med. 377 (23): 2253–2265. doi:10.1056/NEJMra1600673. PMID 29211672.

[pmid2659990-4] Stevens DL, Tanner MH, Winship J, Swarts R, Ries KM, Schlievert PM; et al. (1989). "Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A." N Engl J Med. 321 (1): 1–7. doi:10.1056/NEJM198907063210101. PMID 2659990.

[pmid11202110-5] Simonart T, Simonart JM, Derdelinckx I, De Dobbeleer G, Verleysen A, Verraes S; et al. (2001). "Value of standard laboratory tests for the early recognition of group A beta-hemolytic streptococcal necrotizing fasciitis". Clin Infect Dis. 32 (1): E9–12. doi:10.1086/317525. PMID 11202110.

[pmid17875838-6] Yaghoubian A, de Virgilio C, Dauphine C, Lewis RJ, Lin M (2007). "Use of admission serum lactate and sodium levels to predict mortality in necrotizing soft-tissue infections". Arch Surg. 142 (9): 840–6, discussion 844-6. doi:10.1001/archsurg.142.9.840. PMID 17875838.

[pmid16677887-7] Butterworth SA, Murphy JJ (2006). "Necrotizing soft tissue infections--are they different in healthy vs immunocompromised children?". J Pediatr Surg. 41 (5): 935–9. doi:10.1016/j.jpedsurg.2006.01.012. PMID 16677887.

[pmid10989895-8] Wall DB, Klein SR, Black S, de Virgilio C (2000). "A simple model to help distinguish necrotizing fasciitis from nonnecrotizing soft tissue infection". J Am Coll Surg. 191 (3): 227–31. doi:10.1016/s1072-7515(00)00318-5. PMID 10989895.

[pmid3296102-9] Yoder EL, Mendez J, Khatib R (1987). "Spontaneous gangrenous myositis induced by Streptococcus pyogenes: case report and review of the literature". Rev Infect Dis. 9 (2): 382–5. doi:10.1093/clinids/9.2.382. PMID 3296102.

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@@ Line 10: / Line 10: @@
 *[[Patients]] with [[gangrene]] often have a non-specic [[laboratory findings]].
 *Table 1 lists the commonly requested [[laboratories]] with the usual [[laboratory findings]] in a [[patient]] with [[gangrene]].
 {| style="border: 0px; font-size: 90%; margin: 1px; width: " align="center" 800px;"
 | valign="top" |
-|+<big>''' Table 1. Common [[Laboratory Tests]] Done in the Evaluation of [[Gangene]]. '''</big>
+|+<big>''' Table 1. [[Laboratory Tests]] Commonly Done to Diagnose [[Gangrene]]. '''</big>
 ! align="center" style="background: #00CED1; width: 300px;" |{{fontcolor|#FFF|Laboratory Test}}
-! align="center" style="background: #00CED1; width: 600px;" |{{fontcolor|#FFF|Findings}}
+! align="center" style="background: #00CED1; width: 600px;" |{{fontcolor|#FFF|Findings  <ref name="pmid29211672">{{cite journal| author=Stevens DL, Bryant AE| title=Necrotizing Soft-Tissue Infections. | journal=N Engl J Med | year= 2017 | volume= 377 | issue= 23 | pages= 2253-2265 | pmid=29211672 | doi=10.1056/NEJMra1600673 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29211672  }} </ref> <ref name="pmid2659990">{{cite journal| author=Stevens DL, Tanner MH, Winship J, Swarts R, Ries KM, Schlievert PM | display-authors=etal| title=Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A. | journal=N Engl J Med | year= 1989 | volume= 321 | issue= 1 | pages= 1-7 | pmid=2659990 | doi=10.1056/NEJM198907063210101 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2659990  }} </ref> <ref name="pmid11202110">{{cite journal| author=Simonart T, Simonart JM, Derdelinckx I, De Dobbeleer G, Verleysen A, Verraes S | display-authors=etal| title=Value of standard laboratory tests for the early recognition of group A beta-hemolytic streptococcal necrotizing fasciitis. | journal=Clin Infect Dis | year= 2001 | volume= 32 | issue= 1 | pages= E9-12 | pmid=11202110 | doi=10.1086/317525 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11202110  }} </ref> <ref name="pmid17875838">{{cite journal| author=Yaghoubian A, de Virgilio C, Dauphine C, Lewis RJ, Lin M| title=Use of admission serum lactate and sodium levels to predict mortality in necrotizing soft-tissue infections. | journal=Arch Surg | year= 2007 | volume= 142 | issue= 9 | pages= 840-6; discussion 844-6 | pmid=17875838 | doi=10.1001/archsurg.142.9.840 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17875838  }} </ref> <ref name="pmid16677887">{{cite journal| author=Butterworth SA, Murphy JJ| title=Necrotizing soft tissue infections--are they different in healthy vs immunocompromised children? | journal=J Pediatr Surg | year= 2006 | volume= 41 | issue= 5 | pages= 935-9 | pmid=16677887 | doi=10.1016/j.jpedsurg.2006.01.012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16677887  }} </ref> <ref name="pmid10989895">{{cite journal| author=Wall DB, Klein SR, Black S, de Virgilio C| title=A simple model to help distinguish necrotizing fasciitis from nonnecrotizing soft tissue infection. | journal=J Am Coll Surg | year= 2000 | volume= 191 | issue= 3 | pages= 227-31 | pmid=10989895 | doi=10.1016/s1072-7515(00)00318-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10989895  }} </ref>}}
 |-
 | align="center" style="padding: 2px 2px; background: #E6E6FA; font-weight: bold" |[[Complete Blood Count]]
-| align="center" style="padding: 2px 2px; background: #F5F5F5;" |[[Leukocytosis with left shift]], and [[coagulopathy]]]]. <ref name="pmid29211672">{{cite journal| author=Stevens DL, Bryant AE| title=Necrotizing Soft-Tissue Infections. | journal=N Engl J Med | year= 2017 | volume= 377 | issue= 23 | pages= 2253-2265 | pmid=29211672 | doi=10.1056/NEJMra1600673 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29211672  }} </ref> <ref name="pmid2659990">{{cite journal| author=Stevens DL, Tanner MH, Winship J, Swarts R, Ries KM, Schlievert PM | display-authors=etal| title=Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A. | journal=N Engl J Med | year= 1989 | volume= 321 | issue= 1 | pages= 1-7 | pmid=2659990 | doi=10.1056/NEJM198907063210101 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2659990  }} </ref> <ref name="pmid11202110">{{cite journal| author=Simonart T, Simonart JM, Derdelinckx I, De Dobbeleer G, Verleysen A, Verraes S | display-authors=etal| title=Value of standard laboratory tests for the early recognition of group A beta-hemolytic streptococcal necrotizing fasciitis. | journal=Clin Infect Dis | year= 2001 | volume= 32 | issue= 1 | pages= E9-12 | pmid=11202110 | doi=10.1086/317525 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11202110  }} </ref> <ref name="pmid17875838">{{cite journal| author=Yaghoubian A, de Virgilio C, Dauphine C, Lewis RJ, Lin M| title=Use of admission serum lactate and sodium levels to predict mortality in necrotizing soft-tissue infections. | journal=Arch Surg | year= 2007 | volume= 142 | issue= 9 | pages= 840-6; discussion 844-6 | pmid=17875838 | doi=10.1001/archsurg.142.9.840 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17875838  }} </ref> <ref name="pmid16677887">{{cite journal| author=Butterworth SA, Murphy JJ| title=Necrotizing soft tissue infections--are they different in healthy vs immunocompromised children? | journal=J Pediatr Surg | year= 2006 | volume= 41 | issue= 5 | pages= 935-9 | pmid=16677887 | doi=10.1016/j.jpedsurg.2006.01.012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16677887  }} </ref> <ref name="pmid10989895">{{cite journal| author=Wall DB, Klein SR, Black S, de Virgilio C| title=A simple model to help distinguish necrotizing fasciitis from nonnecrotizing soft tissue infection. | journal=J Am Coll Surg | year= 2000 | volume= 191 | issue= 3 | pages= 227-31 | pmid=10989895 | doi=10.1016/s1072-7515(00)00318-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10989895  }} </ref>
+| align="center" style="padding: 2px 2px; background: #F5F5F5;" |[[Leukocytosis with left shift]], and [[coagulopathy]]].
 |-
 | align="center" style="padding: 2px 2px; background: #E6E6FA; font-weight: bold" |[[Serum Electrolytes]]
-| align="center" style="padding: 2px 2px; background: #F5F5F5;" |[[Hyponatremia]] <ref name="pmid29211672">{{cite journal| author=Stevens DL, Bryant AE| title=Necrotizing Soft-Tissue Infections. | journal=N Engl J Med | year= 2017 | volume= 377 | issue= 23 | pages= 2253-2265 | pmid=29211672 | doi=10.1056/NEJMra1600673 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29211672  }} </ref> <ref name="pmid2659990">{{cite journal| author=Stevens DL, Tanner MH, Winship J, Swarts R, Ries KM, Schlievert PM | display-authors=etal| title=Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A. | journal=N Engl J Med | year= 1989 | volume= 321 | issue= 1 | pages= 1-7 | pmid=2659990 | doi=10.1056/NEJM198907063210101 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2659990  }} </ref> <ref name="pmid11202110">{{cite journal| author=Simonart T, Simonart JM, Derdelinckx I, De Dobbeleer G, Verleysen A, Verraes S | display-authors=etal| title=Value of standard laboratory tests for the early recognition of group A beta-hemolytic streptococcal necrotizing fasciitis. | journal=Clin Infect Dis | year= 2001 | volume= 32 | issue= 1 | pages= E9-12 | pmid=11202110 | doi=10.1086/317525 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11202110  }} </ref> <ref name="pmid17875838">{{cite journal| author=Yaghoubian A, de Virgilio C, Dauphine C, Lewis RJ, Lin M| title=Use of admission serum lactate and sodium levels to predict mortality in necrotizing soft-tissue infections. | journal=Arch Surg | year= 2007 | volume= 142 | issue= 9 | pages= 840-6; discussion 844-6 | pmid=17875838 | doi=10.1001/archsurg.142.9.840 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17875838  }} </ref> <ref name="pmid16677887">{{cite journal| author=Butterworth SA, Murphy JJ| title=Necrotizing soft tissue infections--are they different in healthy vs immunocompromised children? | journal=J Pediatr Surg | year= 2006 | volume= 41 | issue= 5 | pages= 935-9 | pmid=16677887 | doi=10.1016/j.jpedsurg.2006.01.012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16677887  }} </ref> <ref name="pmid10989895">{{cite journal| author=Wall DB, Klein SR, Black S, de Virgilio C| title=A simple model to help distinguish necrotizing fasciitis from nonnecrotizing soft tissue infection. | journal=J Am Coll Surg | year= 2000 | volume= 191 | issue= 3 | pages= 227-31 | pmid=10989895 | doi=10.1016/s1072-7515(00)00318-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10989895  }} </ref>
+| align="center" style="padding: 2px 2px; background: #F5F5F5;" |[[Hyponatremia]]
 |-
 | align="center" style="padding: 2px 2px; background: #E6E6FA; font-weight: bold" |[[C-Reactive Protein]] ([[CRP]])
-| align="center" style="padding: 2px 2px; background: #F5F5F5;" |Elevated [[CRP]] level. <ref name="pmid29211672">{{cite journal| author=Stevens DL, Bryant AE| title=Necrotizing Soft-Tissue Infections. | journal=N Engl J Med | year= 2017 | volume= 377 | issue= 23 | pages= 2253-2265 | pmid=29211672 | doi=10.1056/NEJMra1600673 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29211672  }} </ref> <ref name="pmid2659990">{{cite journal| author=Stevens DL, Tanner MH, Winship J, Swarts R, Ries KM, Schlievert PM | display-authors=etal| title=Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A. | journal=N Engl J Med | year= 1989 | volume= 321 | issue= 1 | pages= 1-7 | pmid=2659990 | doi=10.1056/NEJM198907063210101 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2659990  }} </ref> <ref name="pmid11202110">{{cite journal| author=Simonart T, Simonart JM, Derdelinckx I, De Dobbeleer G, Verleysen A, Verraes S | display-authors=etal| title=Value of standard laboratory tests for the early recognition of group A beta-hemolytic streptococcal necrotizing fasciitis. | journal=Clin Infect Dis | year= 2001 | volume= 32 | issue= 1 | pages= E9-12 | pmid=11202110 | doi=10.1086/317525 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11202110  }} </ref> <ref name="pmid17875838">{{cite journal| author=Yaghoubian A, de Virgilio C, Dauphine C, Lewis RJ, Lin M| title=Use of admission serum lactate and sodium levels to predict mortality in necrotizing soft-tissue infections. | journal=Arch Surg | year= 2007 | volume= 142 | issue= 9 | pages= 840-6; discussion 844-6 | pmid=17875838 | doi=10.1001/archsurg.142.9.840 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17875838  }} </ref> <ref name="pmid16677887">{{cite journal| author=Butterworth SA, Murphy JJ| title=Necrotizing soft tissue infections--are they different in healthy vs immunocompromised children? | journal=J Pediatr Surg | year= 2006 | volume= 41 | issue= 5 | pages= 935-9 | pmid=16677887 | doi=10.1016/j.jpedsurg.2006.01.012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16677887  }} </ref> <ref name="pmid10989895">{{cite journal| author=Wall DB, Klein SR, Black S, de Virgilio C| title=A simple model to help distinguish necrotizing fasciitis from nonnecrotizing soft tissue infection. | journal=J Am Coll Surg | year= 2000 | volume= 191 | issue= 3 | pages= 227-31 | pmid=10989895 | doi=10.1016/s1072-7515(00)00318-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10989895  }} </ref>
+| align="center" style="padding: 2px 2px; background: #F5F5F5;" |Elevated [[CRP]] level.
 |-
 | align="center" style="padding: 2px 2px; background: #E6E6FA; font-weight: bold" |[[Erythrocyte Sedimentation Rate]] ([[ESR]])
-| align="center" style="padding: 2px 2px; background: #F5F5F5;" |Elevated [[ESR]] level. <ref name="pmid29211672">{{cite journal| author=Stevens DL, Bryant AE| title=Necrotizing Soft-Tissue Infections. | journal=N Engl J Med | year= 2017 | volume= 377 | issue= 23 | pages= 2253-2265 | pmid=29211672 | doi=10.1056/NEJMra1600673 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29211672  }} </ref> <ref name="pmid2659990">{{cite journal| author=Stevens DL, Tanner MH, Winship J, Swarts R, Ries KM, Schlievert PM | display-authors=etal| title=Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A. | journal=N Engl J Med | year= 1989 | volume= 321 | issue= 1 | pages= 1-7 | pmid=2659990 | doi=10.1056/NEJM198907063210101 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2659990  }} </ref> <ref name="pmid11202110">{{cite journal| author=Simonart T, Simonart JM, Derdelinckx I, De Dobbeleer G, Verleysen A, Verraes S | display-authors=etal| title=Value of standard laboratory tests for the early recognition of group A beta-hemolytic streptococcal necrotizing fasciitis. | journal=Clin Infect Dis | year= 2001 | volume= 32 | issue= 1 | pages= E9-12 | pmid=11202110 | doi=10.1086/317525 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11202110  }} </ref> <ref name="pmid17875838">{{cite journal| author=Yaghoubian A, de Virgilio C, Dauphine C, Lewis RJ, Lin M| title=Use of admission serum lactate and sodium levels to predict mortality in necrotizing soft-tissue infections. | journal=Arch Surg | year= 2007 | volume= 142 | issue= 9 | pages= 840-6; discussion 844-6 | pmid=17875838 | doi=10.1001/archsurg.142.9.840 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17875838  }} </ref> <ref name="pmid16677887">{{cite journal| author=Butterworth SA, Murphy JJ| title=Necrotizing soft tissue infections--are they different in healthy vs immunocompromised children? | journal=J Pediatr Surg | year= 2006 | volume= 41 | issue= 5 | pages= 935-9 | pmid=16677887 | doi=10.1016/j.jpedsurg.2006.01.012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16677887  }} </ref> <ref name="pmid10989895">{{cite journal| author=Wall DB, Klein SR, Black S, de Virgilio C| title=A simple model to help distinguish necrotizing fasciitis from nonnecrotizing soft tissue infection. | journal=J Am Coll Surg | year= 2000 | volume= 191 | issue= 3 | pages= 227-31 | pmid=10989895 | doi=10.1016/s1072-7515(00)00318-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10989895  }} </ref>
+| align="center" style="padding: 2px 2px; background: #F5F5F5;" |Elevated [[ESR]] level.
 |-
 | align="center" style="padding: 2px 2px; background: #E6E6FA; font-weight: bold" |[[Liver Function Tests]]
-| align="center" style="padding: 2px 2px; background: #F5F5F5;" |Elevated [[Aspartate aminotransferase]] ([[AST]], and [[Alanine aminotransferase]] ([[ALT]]) levels. <ref name="pmid29211672">{{cite journal| author=Stevens DL, Bryant AE| title=Necrotizing Soft-Tissue Infections. | journal=N Engl J Med | year= 2017 | volume= 377 | issue= 23 | pages= 2253-2265 | pmid=29211672 | doi=10.1056/NEJMra1600673 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29211672  }} </ref> <ref name="pmid2659990">{{cite journal| author=Stevens DL, Tanner MH, Winship J, Swarts R, Ries KM, Schlievert PM | display-authors=etal| title=Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A. | journal=N Engl J Med | year= 1989 | volume= 321 | issue= 1 | pages= 1-7 | pmid=2659990 | doi=10.1056/NEJM198907063210101 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2659990  }} </ref> <ref name="pmid11202110">{{cite journal| author=Simonart T, Simonart JM, Derdelinckx I, De Dobbeleer G, Verleysen A, Verraes S | display-authors=etal| title=Value of standard laboratory tests for the early recognition of group A beta-hemolytic streptococcal necrotizing fasciitis. | journal=Clin Infect Dis | year= 2001 | volume= 32 | issue= 1 | pages= E9-12 | pmid=11202110 | doi=10.1086/317525 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11202110  }} </ref> <ref name="pmid17875838">{{cite journal| author=Yaghoubian A, de Virgilio C, Dauphine C, Lewis RJ, Lin M| title=Use of admission serum lactate and sodium levels to predict mortality in necrotizing soft-tissue infections. | journal=Arch Surg | year= 2007 | volume= 142 | issue= 9 | pages= 840-6; discussion 844-6 | pmid=17875838 | doi=10.1001/archsurg.142.9.840 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17875838  }} </ref> <ref name="pmid16677887">{{cite journal| author=Butterworth SA, Murphy JJ| title=Necrotizing soft tissue infections--are they different in healthy vs immunocompromised children? | journal=J Pediatr Surg | year= 2006 | volume= 41 | issue= 5 | pages= 935-9 | pmid=16677887 | doi=10.1016/j.jpedsurg.2006.01.012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16677887  }} </ref> <ref name="pmid10989895">{{cite journal| author=Wall DB, Klein SR, Black S, de Virgilio C| title=A simple model to help distinguish necrotizing fasciitis from nonnecrotizing soft tissue infection. | journal=J Am Coll Surg | year= 2000 | volume= 191 | issue= 3 | pages= 227-31 | pmid=10989895 | doi=10.1016/s1072-7515(00)00318-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10989895  }} </ref>
+| align="center" style="padding: 2px 2px; background: #F5F5F5;" |Elevated [[Alanine aminotransferase]] ([[ALT]], and [[Aspartate aminotransferase]] ([[AST]]) levels.
 |-
 | align="center" style="padding: 2px 2px; background: #E6E6FA; font-weight: bold" |[[Creatine Kinase]] ([[CK]])
-| align="center" style="padding: 2px 2px; background: #F5F5F5;" |Elevated [[CK]] level. <ref name="pmid29211672">{{cite journal| author=Stevens DL, Bryant AE| title=Necrotizing Soft-Tissue Infections. | journal=N Engl J Med | year= 2017 | volume= 377 | issue= 23 | pages= 2253-2265 | pmid=29211672 | doi=10.1056/NEJMra1600673 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29211672  }} </ref> <ref name="pmid2659990">{{cite journal| author=Stevens DL, Tanner MH, Winship J, Swarts R, Ries KM, Schlievert PM | display-authors=etal| title=Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A. | journal=N Engl J Med | year= 1989 | volume= 321 | issue= 1 | pages= 1-7 | pmid=2659990 | doi=10.1056/NEJM198907063210101 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2659990  }} </ref> <ref name="pmid11202110">{{cite journal| author=Simonart T, Simonart JM, Derdelinckx I, De Dobbeleer G, Verleysen A, Verraes S | display-authors=etal| title=Value of standard laboratory tests for the early recognition of group A beta-hemolytic streptococcal necrotizing fasciitis. | journal=Clin Infect Dis | year= 2001 | volume= 32 | issue= 1 | pages= E9-12 | pmid=11202110 | doi=10.1086/317525 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11202110  }} </ref> <ref name="pmid17875838">{{cite journal| author=Yaghoubian A, de Virgilio C, Dauphine C, Lewis RJ, Lin M| title=Use of admission serum lactate and sodium levels to predict mortality in necrotizing soft-tissue infections. | journal=Arch Surg | year= 2007 | volume= 142 | issue= 9 | pages= 840-6; discussion 844-6 | pmid=17875838 | doi=10.1001/archsurg.142.9.840 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17875838  }} </ref> <ref name="pmid16677887">{{cite journal| author=Butterworth SA, Murphy JJ| title=Necrotizing soft tissue infections--are they different in healthy vs immunocompromised children? | journal=J Pediatr Surg | year= 2006 | volume= 41 | issue= 5 | pages= 935-9 | pmid=16677887 | doi=10.1016/j.jpedsurg.2006.01.012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16677887  }} </ref> <ref name="pmid10989895">{{cite journal| author=Wall DB, Klein SR, Black S, de Virgilio C| title=A simple model to help distinguish necrotizing fasciitis from nonnecrotizing soft tissue infection. | journal=J Am Coll Surg | year= 2000 | volume= 191 | issue= 3 | pages= 227-31 | pmid=10989895 | doi=10.1016/s1072-7515(00)00318-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10989895  }} </ref>
+| align="center" style="padding: 2px 2px; background: #F5F5F5;" |Elevated [[CK]] level.
 |-
 | align="center" style="padding: 2px 2px; background: #E6E6FA; font-weight: bold" |[[Lactate]]
-| align="center" style="padding: 2px 2px; background: #F5F5F5;" |Elevated [[lactate]] level. <ref name="pmid29211672">{{cite journal| author=Stevens DL, Bryant AE| title=Necrotizing Soft-Tissue Infections. | journal=N Engl J Med | year= 2017 | volume= 377 | issue= 23 | pages= 2253-2265 | pmid=29211672 | doi=10.1056/NEJMra1600673 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29211672  }} </ref> <ref name="pmid2659990">{{cite journal| author=Stevens DL, Tanner MH, Winship J, Swarts R, Ries KM, Schlievert PM | display-authors=etal| title=Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A. | journal=N Engl J Med | year= 1989 | volume= 321 | issue= 1 | pages= 1-7 | pmid=2659990 | doi=10.1056/NEJM198907063210101 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2659990  }} </ref> <ref name="pmid11202110">{{cite journal| author=Simonart T, Simonart JM, Derdelinckx I, De Dobbeleer G, Verleysen A, Verraes S | display-authors=etal| title=Value of standard laboratory tests for the early recognition of group A beta-hemolytic streptococcal necrotizing fasciitis. | journal=Clin Infect Dis | year= 2001 | volume= 32 | issue= 1 | pages= E9-12 | pmid=11202110 | doi=10.1086/317525 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11202110  }} </ref> <ref name="pmid17875838">{{cite journal| author=Yaghoubian A, de Virgilio C, Dauphine C, Lewis RJ, Lin M| title=Use of admission serum lactate and sodium levels to predict mortality in necrotizing soft-tissue infections. | journal=Arch Surg | year= 2007 | volume= 142 | issue= 9 | pages= 840-6; discussion 844-6 | pmid=17875838 | doi=10.1001/archsurg.142.9.840 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17875838  }} </ref> <ref name="pmid16677887">{{cite journal| author=Butterworth SA, Murphy JJ| title=Necrotizing soft tissue infections--are they different in healthy vs immunocompromised children? | journal=J Pediatr Surg | year= 2006 | volume= 41 | issue= 5 | pages= 935-9 | pmid=16677887 | doi=10.1016/j.jpedsurg.2006.01.012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16677887  }} </ref> <ref name="pmid10989895">{{cite journal| author=Wall DB, Klein SR, Black S, de Virgilio C| title=A simple model to help distinguish necrotizing fasciitis from nonnecrotizing soft tissue infection. | journal=J Am Coll Surg | year= 2000 | volume= 191 | issue= 3 | pages= 227-31 | pmid=10989895 | doi=10.1016/s1072-7515(00)00318-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10989895  }} </ref>
+| align="center" style="padding: 2px 2px; background: #F5F5F5;" |Elevated [[lactate]] level.
 |}
-Evaluation of [[patients]] with [[ischemic]] [[gangrene]] is more focused on targeting the [[risk factors]] which include [[hyperlipidemia]], [[diabetes]], and [[renal failure]]. Laboratory tests to deal with these [[risk factors]] are usually requested for [[ischemic]] [[gangrene]]. [[Wet gangrene]] and [[gas gangrene]] are assessed with the help of [[cultures]].<ref name="pmid25439329">{{cite journal| author=Elsayed S, Clavijo LC| title=Critical limb ischemia. | journal=Cardiol Clin | year= 2015 | volume= 33 | issue= 1 | pages= 37-47 | pmid=25439329 | doi=10.1016/j.ccl.2014.09.008 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25439329  }} </ref> <ref name="pmid31159978">{{cite journal| author=Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R | display-authors=etal| title=Global vascular guidelines on the management of chronic limb-threatening ischemia. | journal=J Vasc Surg | year= 2019 | volume= 69 | issue= 6S | pages= 3S-125S.e40 | pmid=31159978 | doi=10.1016/j.jvs.2019.02.016 | pmc=8365864 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31159978  }} </ref>  Table 1 summarizes the types of [[gangrene]] and the [[laboratory tests]] needed for each type.
+*Evaluation of [[patients]] with [[ischemic]] [[gangrene]] is more focused on targeting the [[risk factors]] which include [[hyperlipidemia]], [[diabetes]], and [[renal failure]].
+*[[Laboratory tests]] to deal with these [[risk factors]] are usually requested for [[ischemic]] [[gangrene]].
+*[[Wet gangrene]] and [[gas gangrene]] are assessed with the help of [[cultures]].<ref name="pmid25439329">{{cite journal| author=Elsayed S, Clavijo LC| title=Critical limb ischemia. | journal=Cardiol Clin | year= 2015 | volume= 33 | issue= 1 | pages= 37-47 | pmid=25439329 | doi=10.1016/j.ccl.2014.09.008 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25439329  }} </ref> <ref name="pmid31159978">{{cite journal| author=Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R | display-authors=etal| title=Global vascular guidelines on the management of chronic limb-threatening ischemia. | journal=J Vasc Surg | year= 2019 | volume= 69 | issue= 6S | pages= 3S-125S.e40 | pmid=31159978 | doi=10.1016/j.jvs.2019.02.016 | pmc=8365864 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31159978  }} </ref>  <ref name="pmid3296102">{{cite journal| author=Yoder EL, Mendez J, Khatib R| title=Spontaneous gangrenous myositis induced by Streptococcus pyogenes: case report and review of the literature. | journal=Rev Infect Dis | year= 1987 | volume= 9 | issue= 2 | pages= 382-5 | pmid=3296102 | doi=10.1093/clinids/9.2.382 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3296102  }} </ref>
+*Table 2 summarizes the types of [[gangrene]] and the [[laboratory tests]] needed for each type.
-{| style="border: 0px; font-size: 90%; margin: 1px; width: " align="center" 800px;"
+{| style="border: 0px; font-size: 90%; margin: 1px; width: " align="center" 600px;"
 | valign="top" |
-|+<big>''' Table 2. [[Laboratory Findings]] of a Person with [[Gangene]].'''</big>
+|+<big>''' Table 2. Types of [[Gangrene]] and their Respective [[Laboratory Tests]].'''</big>
 ! align="center" style="background: #00CED1; width: 300px;" |{{fontcolor|#FFF|Type of Gangrene}}
-! align="center" style="background: #00CED1; width: 600px;" |{{fontcolor|#FFF|Laboratory Tests Needed}}
+! align="center" style="background: #00CED1; width: 300px;" |{{fontcolor|#FFF|Laboratory Tests Needed}}
-|-
-| align="center" style="padding: 2px 2px; background: #E6E6FA; font-weight: bold" |[[Dry Gangrene]]
-| align="center" style="padding: 2px 2px; background: #F5F5F5;" |Ankle-Brachial Index
 |-
 | align="center" style="padding: 2px 2px; background: #E6E6FA; font-weight: bold" |[[Wet Gangrene]]
@@ Line 59: / Line 60: @@
 | align="center" style="padding: 2px 2px; background: #F5F5F5;" |[[Gram Stain]], [[wound]] [[culture]]
 |}
+*The following are the common microorganisms found in the [[culture]] of [[wound specimens]] with [[gangrene]].
+**''Clostridium perfringens''
+**''Clostridium sordellii''
+**''Clostridium septicum''
 ==References==
@@ Line 67: / Line 74: @@
 [[Category:Emergency medicine]]
 [[Category:Intensive care medicine]]
-[[Category:Needs content]]
+[[Category:Up to Date]]
-{{WH}}
-{{WS}}

Gangrene laboratory findings: Difference between revisions

Latest revision as of 17:46, 14 July 2022

Overview

Laboratory Findings

References

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