Necrotizing fasciitis with prior leprosy: a case report
Keywords:Necrotizing fasciitis, Leprosy, Laboratory risk Indicator for necrotizing fasciitis, Early diagnosis, Delayed diagnosis
Necrotizing fasciitis (NF) is a life-threatening soft tissue infection with a high misdiagnosis rate. Here, we present the case of NF with hypoesthesia due to prior leprosy in a limited resource area. Laboratory risk indicator for NF (LRINEC) score was used to determine the diagnosis of NF. Resuscitation and broad-spectrum antibiotic were initiated, followed by surgical debridement due to lack of wound improvement and skin graft to cover the wound was done. This case report highlights the usage of LRINEC score to reduce misdiagnosis, ensure early diagnosis, and improve patient management in NF with masking effect.
Adekanye AG, Umana AN, Offiong ME, Mgbe RB, Owughalu BC, Inyama M, et al. Cervical necrotizing fasciitis: management challenges in poor resource environment. Eur Arch Otorhinolaryngol. 2016;273:2779-84.
Hietbrink F, Bode LG, Riddez L, Leenen LPH, van Dijk MR. Triple diagnostics for early detection of ambivalent necrotizing fasciitis. World J Emerg Surg. 2016;11:51.
Goh T, Goh LG, Ang CH, Wong CH. Early diagnosis of necrotizing fasciitis. Br J Surg. 2014;101:e119-25.
Bechar J, Sepehripour S, Hardwicke J, Filobbos G. Laboratory risk indicator for necrotising fasciitis (LRINEC) score for the assessment of early necrotising fasciitis: a systematic review of the literature. Ann R Coll Surg Engl. 2017;99:341-6.
Fernando SM, Tran A, Cheng W, Rochwerg B, Kyeremanteng K, Seely AJE, et al. Necrotizing soft tissue infection: diagnostic accuracy of physical examination, imaging, and LRINEC score: a systematic review and meta-analysis. Ann Surg. 2019;269:58-65.
Misiakos EP, Bagias G, Patapis P, Sotiropoulos D, Kanavidis P, Machairas A. Current concepts in the management of necrotizing fasciitis. Front Surg. 2014;1:36.
Vijayakumar A, Pullagura R, Thimmappa D. Necrotizing fasciitis: diagnostic challenges and current practices. ISRN Infect Dis. 2014;2014:1-8.
Brar N, Dhaliwal JS, Singh A, Bajwa R. Clinicopathology study of necrotizing fasciitis with special reference to Fournier’s gangrene. Int Surg J. 2017;4:3492-8.
Anaya DA, McMahon K, Nathens AB, Sullivan SR, Foy H, Bulger E. Predictors of mortality and limb loss in necrotizing soft tissue infections. Arch Surg. 2005;140:151-7.
Espandar R, Sibdari SY, Rafiee E, Yazdanian S. Necrotizing fasciitis of the extremities: a prospective study. Strategies Trauma Limb Reconstr. 2011;6:121-5.
Kiat HJ, En Natalie YH, Fatimah L. Necrotizing fasciitis: how reliable are the cutaneous signs? J Emerg Trauma Shock. 2017;10:205-10.
Misiakos EP, Bagias G, Papadopoulos I, Danias N, Patapis P, Machairas N, et al. Early diagnosis and surgical treatment for necrotizing fasciitis: a multicenter study. Front Surg. 2017;4:5.
El-Menyar A, Asim M, Mudali IN, Mekkodathil A, Latifi R, Al-Thani H. The laboratory risk indicator for necrotizing fasciitis (LRINEC) scoring: the diagnostic and potential prognostic role. Scand J Trauma Resusc Emerg Med. 2017;25:28.