Necrotizing fasciitis - a case series

Abstract

Necrotizing Fasciitis is a rapidly progressing soft tissue infection primarily involving the superficial fascia and subcutaneous tissue.

In this case series, we reviewed the clinical presentation of the Necrotising fasciitis cases, the critical role of early diagnosis, to assess the important predictor of mortality and importance of LRINEC scores in proven cases. The data was collected prospectively and retrospectively for 16 consecutive patients who were admitted at our institution with Necrotising Fascitis between January 2010 and April 2018. Patients were subdivided in to two sub groups, survived (n= 12) and deceased (n=4).

The both groups were assessed in terms of age, gender, predisposing factors and the difference between the LRINEC score.

Age ranged from 30 to 77 years (average age 54.6). The most common associated comorbidity was DM in 6, followed by IVDU in 3 patients.

We noted mean LRINEC score 9.5 in those patients who survived and 9.75 with mortality group.

Group statistics revealed the age is an important factor for predicting high mortality and diabetes mellitus being the most common comorbid condition. We noted that streptococci and staphylococci remain the virulent and commonest organism.

We noted that LRINEC score is an important to predict the morbidity and mortality as the mean score was 9.5 (range 6-12), but no significant difference in the LRINEC score noted in the deceased vs survived group. We strongly recommend the high clinical suspicion, prompt investigations and resuscitation with appropriate antimicrobial therapy followed by expedited surgical debridement to reduce the morbidity and mortality.