Going Out on a Limb

Sturgeon, Jonathan P; Segal, Laura; Verma, Anita

doi:10.1097/pec.0000000000000255

Cited by 15 publications

(3 citation statements)

References 50 publications

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“…In summary, the differences in clinical presentation of skin involvement in NF as compared to cellulitis were not dramatic and highlight the difficulties in differentiating NF from cellulitis clinically in an early stage [ 15 ]. In most cases, NF resulted from larger trauma as compared to cellulitis leading to a more broad distribution of affected body sites.…”

Section: Resultsmentioning

confidence: 99%

Improvement of a Clinical Score for Necrotizing Fasciitis: ‘Pain Out of Proportion’ and High CRP Levels Aid the Diagnosis

Borschitz¹,

Schlicht

Siegel

et al. 2015

PLoS ONE

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Necrotizing fasciitis (NF) is a rare mono-/polymicrobial skin infection that spreads to underlying tissues. NF is quickly progressing and leads to life threatening situations. Immediate surgical debridement together with i.v. antibiotic administration is required to avoid fatal outcome. Early diagnosis is often delayed due to underestimation or confusion with cellulitis. We now compared the initial clinical and laboratory presentation of NF and cellulitis in detail to assess if a typical pattern can be identified that aids timely diagnosis of NF and avoidance of fatal outcome. 138 different clinical and laboratory features of 29 NF patients were compared to those of 59 age- and gender matched patients with severe erysipelas requiring a subsequent hospitalization time of ≥10 days. Differences in clinical presentation were not obvious; however, NF patients suffered significantly more often from strong pain. NF patients exhibited dramatically elevated CRP levels (5-fold, p>0.001). The overall laboratory risk indicator for necrotizing fasciitis (LRINEC) score was significantly higher in NF patients as compared to cellulitis. However, a modification of the score (alteration of laboratory parameters, addition of clinical parameters) led to a clear improvement of the score with a higher positive predictive value without losing specificity. In summary, clinical differentiation of NF from cellulitis appears to be hard. ‘Pain out of proportion’ may be an early sign for NF. An improvement of the LRINEC score emphasizing only relevant laboratory and clinical findings as suggested may aid the early diagnosis of NF in the future leading to improvement of disease outcome by enabling rapid adequate therapy.

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Section: Resultsmentioning

confidence: 99%

Improvement of a Clinical Score for Necrotizing Fasciitis: ‘Pain Out of Proportion’ and High CRP Levels Aid the Diagnosis

Borschitz¹,

Schlicht

Siegel

et al. 2015

PLoS ONE

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“…Recent varicella zoster infection is a major risk factor, the mean time from onset of rash to hospital admission is about five days21…”

Section: How Does Gas Infection Present?mentioning

confidence: 99%

Group A beta-haemolytic streptococcal infection in children

Morgan,

Shaw,

Ali

et al. 2024

BMJ

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“…50 Sturgeon et al declared that chicken pox is common and self-limiting, but it can be complicated by NF, with a 3.4% mortality rate. 51 Complication with or progression to streptococcal toxic shock syndrome complicates 37% of NF infections in varicella zoster virus, with a 4-fold increase in mortality rate. Shaw et al suggested that hyperbaric oxygen therapy is associated with a significant survival benefit.…”

Section: Summary Of Latest Research On Erysipelas Cellulitis and Necr...mentioning

confidence: 99%

Bacterial Skin Infections: Epidemiology and Latest Research

Mistik¹,

Uludağ²,

Kartal³

et al. 2015

TJFMPC

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Skin infections are very common throughout the world. The prevalence of skin infections has been reported as follows: pyoderma (prevalence range 0.2-35%, 6.9-35% in Sub-Saharan Africa), tinea capitis (1-19.7%), scabies (0.2-24%, 1.3-17% in Sub-Saharan Africa), viral skin disorders (0.4-9%, mainly molluscum contagiosum), pediculosis capitis (0-57%). Bacterial skin infections are the most common type of skin infections. The most common bacterial skin infections are reported as impetigo, folliculitis, furunculosis and abscesses, cellulitis, scarlet fever, erysipelas, erythrasma, necrotizing fasciitis and some others. In addition to these, ecthyma, carbunculosis, and mycobacterium skin infections are discussed in this review. The latest research gives us the information on the recent change in the bacterial etiology and treatment of bacterial skin infections. The increase in methicillin-resistant S. aureus (MRSA) in impetigo has recently shown us the necessity of being more careful in regard to its treatment. There are also new measures to prevent skin infections, such as the use of maternal zinc supplementation.

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Going Out on a Limb

Cited by 15 publications

References 50 publications

Improvement of a Clinical Score for Necrotizing Fasciitis: ‘Pain Out of Proportion’ and High CRP Levels Aid the Diagnosis

Improvement of a Clinical Score for Necrotizing Fasciitis: ‘Pain Out of Proportion’ and High CRP Levels Aid the Diagnosis

Group A beta-haemolytic streptococcal infection in children

Bacterial Skin Infections: Epidemiology and Latest Research

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