Necrotizing Soft-Tissue Infection: Laboratory Risk Indicator for Necrotizing Soft Tissue Infections Score
Necrotizing soft tissue infections (NSTI) can be rapidly progressive and polymicrobial in etiology. Establishing the element of necrotizing infection poses a clinical challenge. A 64-year-old diabetic patient presented to our hospital with a gangrenous patch on anterior abdominal wall, which progres...
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doaj-7bf490edfe5943e8834472cc9818714c2020-11-25T03:14:46ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Laboratory Physicians0974-27270974-78262014-01-0160104604910.4103/0974-2727.129092Necrotizing Soft-Tissue Infection: Laboratory Risk Indicator for Necrotizing Soft Tissue Infections ScoreMadhuri Kulkarni0Vijay Kumar GS1Sowmya GS2Madhu CP3Ramya SR4Department of Microbiology, JSS Medical College, Mysore, Karnataka, IndiaDepartment of Microbiology, JSS Medical College, Mysore, Karnataka, IndiaDepartment of Microbiology, JSS Medical College, Mysore, Karnataka, IndiaDepartment of Surgery, JSS Medical College, Mysore, Karnataka, IndiaDepartment of Microbiology, JSS Medical College, Mysore, Karnataka, IndiaNecrotizing soft tissue infections (NSTI) can be rapidly progressive and polymicrobial in etiology. Establishing the element of necrotizing infection poses a clinical challenge. A 64-year-old diabetic patient presented to our hospital with a gangrenous patch on anterior abdominal wall, which progressed to an extensive necrotizing lesion within 1 week. Successive laboratory risk indicator for necrotizing softtissue infections (LRINEC) scores confirmed the necrotizing element. Cultures yielded Enterococci, Acinetobacter species and Apophysomyces elegans and the latter being considered as an emerging agent of Zygomycosis in immunocompromised hosts. Patient was managed with antibiotics, antifungal treatment and surgical debridement despite which he succumbed to the infection. NSTI’s require an early and aggressive management and LRINEC score can be applied to establish the element of necrotizing pathology. Isolation of multiple organisms becomes confusing to establish the etiological role. Apophysomyces elegans, which was isolated in our patient is being increasingly reported in cases of necrotizing infections and may be responsible for high morbidity and mortality. This scoring has been proposed as an adjunct tool to Microbiological diagnosis when NSTI’s need to be diagnosed early and managed promptly to decrease mortality and morbidity, which however may not come in handy in an immunocompromised host with polymicrobial aggressive infection.http://www.thieme-connect.de/DOI/DOI?10.4103/0974-2727.129092laboratory risk indicator for necrotizing soft tissue infections scorenecrotizing infectionzygomycosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Madhuri Kulkarni Vijay Kumar GS Sowmya GS Madhu CP Ramya SR |
spellingShingle |
Madhuri Kulkarni Vijay Kumar GS Sowmya GS Madhu CP Ramya SR Necrotizing Soft-Tissue Infection: Laboratory Risk Indicator for Necrotizing Soft Tissue Infections Score Journal of Laboratory Physicians laboratory risk indicator for necrotizing soft tissue infections score necrotizing infection zygomycosis |
author_facet |
Madhuri Kulkarni Vijay Kumar GS Sowmya GS Madhu CP Ramya SR |
author_sort |
Madhuri Kulkarni |
title |
Necrotizing Soft-Tissue Infection: Laboratory Risk Indicator for Necrotizing Soft Tissue Infections Score |
title_short |
Necrotizing Soft-Tissue Infection: Laboratory Risk Indicator for Necrotizing Soft Tissue Infections Score |
title_full |
Necrotizing Soft-Tissue Infection: Laboratory Risk Indicator for Necrotizing Soft Tissue Infections Score |
title_fullStr |
Necrotizing Soft-Tissue Infection: Laboratory Risk Indicator for Necrotizing Soft Tissue Infections Score |
title_full_unstemmed |
Necrotizing Soft-Tissue Infection: Laboratory Risk Indicator for Necrotizing Soft Tissue Infections Score |
title_sort |
necrotizing soft-tissue infection: laboratory risk indicator for necrotizing soft tissue infections score |
publisher |
Thieme Medical and Scientific Publishers Pvt. Ltd. |
series |
Journal of Laboratory Physicians |
issn |
0974-2727 0974-7826 |
publishDate |
2014-01-01 |
description |
Necrotizing soft tissue infections (NSTI) can be rapidly progressive and polymicrobial in etiology. Establishing the element of necrotizing infection poses a clinical challenge. A 64-year-old diabetic patient presented to our hospital with a gangrenous patch on anterior abdominal wall, which progressed to an extensive necrotizing lesion within 1 week. Successive laboratory risk indicator for necrotizing softtissue infections (LRINEC) scores confirmed the necrotizing element. Cultures yielded Enterococci, Acinetobacter species and Apophysomyces elegans and the latter being considered as an emerging agent of Zygomycosis in immunocompromised hosts. Patient was managed with antibiotics, antifungal treatment and surgical debridement despite which he succumbed to the infection. NSTI’s require an early and aggressive management and LRINEC score can be applied to establish the element of necrotizing pathology. Isolation of multiple organisms becomes confusing to establish the etiological role. Apophysomyces elegans, which was isolated in our patient is being increasingly reported in cases of necrotizing infections and may be responsible for high morbidity and mortality. This scoring has been proposed as an adjunct tool to Microbiological diagnosis when NSTI’s need to be diagnosed early and managed promptly to decrease mortality and morbidity, which however may not come in handy in an immunocompromised host with polymicrobial aggressive infection. |
topic |
laboratory risk indicator for necrotizing soft tissue infections score necrotizing infection zygomycosis |
url |
http://www.thieme-connect.de/DOI/DOI?10.4103/0974-2727.129092 |
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