Necrotizing fasciitis laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]

Laboratory Findings

Laboratory tests consistent with diagnosis of necrotizing fasciitis include:

Microbiology

The following are the tests used to diagnose the causative organism:

• Gram stain and culture of tissues and aspirates
• Blood culture
• Culture of throat and vaginal swabs
• Fungal culture (immunocompromised or trauma patients)
• Enrichment cultures (patients with recent antibiotic use)

Haematology

• Complete blood picture

• Rapidly falling heamoglobin
• Leucocytosis (>14,000/µL)
• Leucopenia (if associated with STSS)
• Lymphopenia
• Thrombocytopenia

Boichemistry

• Elevated C-reactive protein
• Elevated serum creatinine kinase
• Hypocalcemia (sign of severity in synergistic NF)
• Hypoalbuminemia
• Hyponatremia (<135mmol/L)
• Elevated serum lactate levels (high serum lactate combined with low sodium levels may be predictive of mortality)
• Arterial blood gas analysis
• Urine analysis
• Elevated Blood urea nitrogen (BUN)

Biopsy

• Deep incisional biopsy (include advancing edge and central necrotic areas)