一例实验室坏死性筋膜炎严重程度评分（LRINEC）为零的坏死性筋膜炎病例：临床怀疑应胜过评分系统。
A case of necrotizing fasciitis with a LRINEC score of zero: clinical suspicion should trump scoring systems.
作者信息
Wilson Michael P, Schneir Aaron B
机构信息
Department of Emergency Medicine, UC San Diego Health System, San Diego, California, USA.
出版信息
J Emerg Med. 2013 May;44(5):928-31. doi: 10.1016/j.jemermed.2012.09.039. Epub 2012 Dec 31.
BACKGROUND
Necrotizing fasciitis (NF) is a potentially lethal infection involving the skin, subcutaneous tissue, and fascia. The Laboratory Risk Indicator for Necrotizing fasciitis (LRINEC) score has been proposed as a way of using abnormal laboratory values to distinguish between severe cellulitis and necrotizing fasciitis.
OBJECTIVES
The utility of the LRINEC system, including a review of current literature on this scoring system, is discussed.
CASE REPORT
A case of a 37-year-old man is presented. As part of the diagnostic work-up, appropriate laboratory tests necessary to calculate a LRINEC score were obtained. Despite a LRINEC score of 0, NF was later confirmed at surgery.
CONCLUSIONS
Although the LRINEC score has been proposed as a robust way of identifying patients with early NF, it failed to detect NF in the patient reported here. NF should thus remain primarily a disease of clinical suspicion, and this suspicion should trump the LRINEC score.
背景
坏死性筋膜炎（NF）是一种可能致命的感染，累及皮肤、皮下组织和筋膜。坏死性筋膜炎实验室风险指标（LRINEC）评分被提出作为一种利用异常实验室值来区分严重蜂窝织炎和坏死性筋膜炎的方法。
目的
讨论LRINEC系统的实用性，包括对关于该评分系统的当前文献的综述。
病例报告
介绍了一名37岁男性的病例。作为诊断检查的一部分，获取了计算LRINEC评分所需的适当实验室检查结果。尽管LRINEC评分为0，但该患者后来在手术中被确诊为坏死性筋膜炎。
结论
尽管LRINEC评分被提出作为识别早期坏死性筋膜炎患者的可靠方法，但它未能在此报告的患者中检测出坏死性筋膜炎。因此，坏死性筋膜炎应主要仍是一种临床怀疑的疾病，这种怀疑应优先于LRINEC评分。
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