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Predictive Accuracy of the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score in Forecasting Mortality and Morbidity Among Necrotizing Fasciitis Patients at a Tertiary Care Hospital in Islamabad.

BACKGROUND: Necrotizing fasciitis (NF) is a rapidly progressive, life-threatening soft tissue infection associated with high morbidity and mortality if not diagnosed and treated early. Due to its often subtle clinical presentation, early identification remains a diagnostic challenge. OBJECTIVE: This study aimed to determine the predictive accuracy of the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score in forecasting disease-specific mortality and morbidity (sepsis) among patients admitted with NF. METHODOLOGY: This is a validation study conducted at the Department of Surge…

Retroperitoneal necrotizing fasciitis masquerading as perforated viscus: a rare case report.

INTRODUCTION AND IMPORTANCE: Necrotizing fasciitis is a rapidly progressive, life-threatening soft-tissue infection associated with high mortality, particularly when diagnosis is delayed. While most cases involve the extremities or perineum, retroperitoneal necrotizing fasciitis is exceedingly rare. Its deep anatomical location often results in vague clinical presentations, allowing extensive infection before overt signs develop, which poses significant diagnostic and therapeutic challenges. Early recognition and timely intervention are critical to improving outcomes. PRESENTATION OF CASE: We…

Efficacy of TOPAZ coblation-assisted percutaneous fasciotomy in chronic plantar fasciitis.

BACKGROUND: Plantar fasciitis is one of the most common causes of chronic heel pain, accounting for up to 10 % of running-related injuries and significantly impacting the quality of life in both active and sedentary populations. While the majority of patients respond to conservative measures such as stretching, physiotherapy, orthoses, steroid injections, and extracorporeal shockwave therapy, approximately 5-10 % remain symptomatic despite prolonged non-operative treatment. Surgical intervention is considered in these refractory cases, with both open and endoscopic plantar fasciotomy tradition…

Necrotizing fasciitis following rapidly deteriorating neonatal omphalitis with good initial presentation.

Neonatal omphalitis is a postpartum infection of periumbilical superficial soft tissues that usually has a good prognosis in developed countries. In rare cases, it could progress to periumbilical necrotizing fasciitis (NF), which is an infection of the deep soft tissues, including muscle fascia, and has a high mortality rate. However, the signs and timing of developing NF secondary to omphalitis are unclear. We encountered a neonatal case of NF following omphalitis. In the initial days of the clinical course, general symptoms and condition of the patient were good, and abdominal physical findi…

Physiotherapy Rehabilitation Following Lower Extremity Split Skin Grafting in Necrotizing Fasciitis.

Necrotizing fasciitis is defined as a highly progressive microbial infection. The diagnosis of necrotizing fasciitis is mostly based on clinical signs, and early diagnosis is key. There are several difficulties that patients confront following surgery. Physical therapy helps to regain the functional range of motion, enhance muscle strength, reduce stiffness and make the patient self-independent. We presented a case of a 54-year-old male with presenting complaints of pain over right lower limb while doing movements and difficulty in performing daily activities. The patient was diagnosed with ne…

Prognostic Role of Subsequent Thrombocytopenia in Necrotizing Fasciitis Without Liver Disease.

BACKGROUND: Necrotizing fasciitis (NF) is a life-threatening disease with a fulminant presentation. Although early diagnosis can be aided by combining physical examination, the Laboratory Risk Indicator for Necrotizing Fasciitis score, and computed tomography, a mortality rate of 30% is still reported. In the modern times, an economical and efficient biomarker for predicting mortality in NF patients is still lacking. Platelet count is typically measured in routine blood tests and aids in predicting disease severity. We aimed to clarify the role of platelet count as a predictive factor for aspe…

Paraspinal Necrotizing Fasciitis Associated with Pressure Injury: An Unusual Case Report.

Necrotizing fasciitis is a type of soft tissue infection that destroys subcutaneous tissue. It is particularly dangerous for patients with chronic diseases and those who are bedridden while recuperating. Although necrotizing fasciitis is often caused by trauma or postoperative infection, in rare cases, it can be attributed to pressure injury (PI). The disease progression is very aggressive and can be lethal for patients who are bedridden or immunocompromised.This case report describes a 47-year-old man with a history of diabetes and hypertension who became bedridden after a sudden status decli…

Варичелла Зостер вирусная инфекция, осложненная некротизирующим фасциитом: отчет по делу.

Некротизирующий фасциит - редкое осложнение вирусной инфекции варицелла-зостер у взрослых, вызванное вторичной бактериальной инфекцией. У 35-летней здоровой пациентки была зостерская инфекция после варицелла с использованием АНБИД в качестве возможного фактора риска. У нее был диагностирован ранний диагноз по клиническим и лабораторным параметрам.

Совпадение в аннотации оригинала
Necrotizing fasciitis is a rare complication of varicella-zoster viral infection in adults, occurring due to a secondary bacterial infection. A 35-year-old female healthy patient had post-varicella zoster infection with NSAID use as a possible risk factor. She was diagnosed early by clinical and laboratory parameters.

Low 68Ga-PSMA PET/CT Uptake in Chronic Intramuscular Nodular Fasciitis.

Nodular fasciitis is an uncommon benign mass-forming myofibroblastic proliferation, most frequently found in the upper limbs, with only rare intramuscular cases. We describe herein a case of chronic nodular fasciitis of the left triceps muscle with a low Ga-labeled prostate-specific membrane antigen (PSMA) ligand uptake on PET/CT. Ga-PSMA ligands bind to PSMA-expressing prostate cancer cells, but uptake has also been demonstrated in other solid neoplasms and various benign lesions. Nodular fasciitis should be included in the differential diagnosis of soft tissue lesions with variable Ga-PSMA u…

Vigorous exercise-induced unilateral eosinophilic fasciitis: rare and easily misdiagnosed subtype.

The hallmark of eosinophilic fasciitis (EF) is painful symmetric skin stiffness and limb sclerosis with deep fascia inflammation. Two cases of unilateral EF have been reported in the literature but were not related to strenuous physical activity. In this report, a young female presenting with unilateral scleroderma-like skin changes, blood and tissue eosinophilia, and hypergammaglobulinemia proven to be EF after strenuous physical activity is described. This case represents the first case reported in the current literature of unilateral EF after vigorous exercise. A skin to muscle biopsy and m…

Steroid-resistant eosinophilic fasciitis successfully treated with addition of extracorporeal photopheresis.

Eosinophilic fasciitis (EF) is an uncommon fibrosing disease of the fascia with characteristic cutaneous and hematologic manifestations. Although EF is most commonly treated with corticosteroids at the beginning, a considerable number of patients show an inadequate response and hence various therapeutic strategies have been tried, including extracorporeal photopheresis (ECP). We describe the case of a 66-year-old woman with steroid-resistant EF that improved significantly after ECP was added to her treatment regimen. To date, only six cases of this therapeutic strategy have been reported in En…

Perforated caecal carcinoma masquerading as lower limb necrotising fasciitis: lessons learnt.

A 69-year-old man was admitted with non-resolving right leg cellulitis. Subsequent skin changes over the calf and discharging pus suggested necrotising fasciitis. After several wound debridements of the leg and imaging, the patient was found to have an iliopsoas abscess due to a metastatic perforated caecal tumour extending along the medial thigh to the calf. No micro-organisms indicative of typical necrotising fasciitis were isolated from the wound. The patient had an ileocaecal resection, and his leg was reconstructed with a split thickness skin graft. He continues to do well postoperatively…

Necrotizing fasciitis with pulmonary septic emboli following an infected insect bite.

Although systemic infections originating from skin infections caused by insect bites are uncommon, it is imperative to maintain a broad differential diagnosis should patients develop systemic symptoms. Necrotizing fasciitis is a rare diagnosis, and progression to septic pulmonary emboli is even less common. Emergent identification and aggressive treatment of these two disease processes are imperative as both carry high rates of morbidity and mortality.

Pyoderma Gangrenosum Masquerading as Necrotizing Fasciitis: Stepping Away from Cognitive Shortcuts.

UNLABELLED: A patient with post-Cesarean wound complication was treated for necrotizing fasciitis (NF) with sharp debridement and broad-spectrum antibiotics. Several operations and three weeks later, her abdominal skin, subcutaneous fat, right-sided rectus abdominus, and underlying fascia had been removed without any improvement in granulation tissue. Original pathology samples demonstrated sheets of necrosis consistent with NF, but were re-reviewed by a dermatopathologist who diagnosed the patient with pyoderma gangrenosum (PG). She was started on high-dose steroids and dapsone, and her wound…

Lower extremity necrotizing fasciitis: A unique initial presentation of Crohn's disease.

Crohn's disease is a disease of the bowel, typically presenting with diarrhea, weight loss, and abdominal pain. Complications such as abscesses, fistulas, and strictures may require surgical intervention. We would like to report a patient with Crohn's disease who presented for the first time with left lower extremity necrotizing fasciitis. There are very few reports of necrotizing fasciitis in Crohn's disease as the initial presentation.

Fungal necrotizing fasciitis, an emerging infectious disease caused by Apophysomyces (Mucorales).

BACKGROUND: The mucoralean fungi are emerging causative agents of primary cutaneous infections presenting in the form of necrotizing fasciitis. AIMS: The aim of this study was to investigate a series of suspected necrotizing fasciitis cases by Apophysomyces species over one-year period in a northern Indian hospital. METHODS: The clinical details of those patients suspected to suffer from fungal necrotizing fasciitis were recorded. Skin biopsies from local wounds were microscopically examined and fungal culturing was carried out on standard media. The histopathology was evaluated using conven…