Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan.
J Dermatol. 2022 Jun;49(6):637-641. doi: 10.1111/1346-8138.16377. Epub 2022 Mar 30.
Necrotizing fasciitis is a rare and severe infectious disease that is often fatal and is characterized by the extensive necrosis of subcutaneous tissue and fascial planes. A number of clinical parameters have been intensively investigated to diagnose and assess the severity and prognosis of necrotizing fasciitis. Since it currently remains unclear whether these parameters are also abnormal before disease onset, the present study investigated this issue. We retrospectively recruited 38 patients, including 12 and 26 patients with necrotizing fasciitis and cellulitis, respectively. The results of routine blood examinations were collected at disease onset and also at baseline, which was defined as the time point before disease onset. No significant differences were observed in age or sex between the necrotizing fasciitis and cellulitis groups. However, significant differences were noted in the levels of hemoglobin, lymphocyte count, platelet count, neutrophil-to-lymphocyte ratio, sodium, creatinine, albumin, D-dimer, and Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score at disease onset. Significant differences were also observed in the levels of hemoglobin, lymphocyte count, monocyte count, platelet count, creatinine, D-dimer, and LRINEC score at baseline. Hemoglobin, platelet count, C-reactive protein, creatinine, albumin, and D-dimer levels were already abnormal at baseline in the necrotizing fasciitis group. In conclusion, the present results revealed precritical abnormalities in routine blood parameters in patients with necrotizing fasciitis. Therefore, individuals predisposed to necrotizing soft tissue infection may be identified prior to disease onset.
坏死性筋膜炎是一种罕见且严重的感染性疾病,常导致死亡,其特征为广泛的皮下组织和筋膜坏死。许多临床参数已被深入研究,用于诊断、评估坏死性筋膜炎的严重程度和预后。由于目前尚不清楚这些参数在疾病发作前是否也异常,因此本研究对此进行了调查。我们回顾性招募了 38 名患者,其中包括 12 名坏死性筋膜炎患者和 26 名蜂窝织炎患者。在疾病发作时和基线时(定义为疾病发作前的时间点)收集了常规血液检查的结果。坏死性筋膜炎和蜂窝织炎组在年龄或性别方面无显著差异。然而,在疾病发作时,血红蛋白、淋巴细胞计数、血小板计数、中性粒细胞与淋巴细胞比值、钠、肌酐、白蛋白、D-二聚体和实验室风险指数坏死性筋膜炎(LRINEC)评分存在显著差异。在基线时,血红蛋白、淋巴细胞计数、单核细胞计数、血小板计数、肌酐、D-二聚体和 LRINEC 评分也存在显著差异。血红蛋白、血小板计数、C 反应蛋白、肌酐、白蛋白和 D-二聚体水平在坏死性筋膜炎组的基线时已经异常。总之,本研究结果揭示了坏死性筋膜炎患者常规血液参数在临界值之前的异常。因此,可能在疾病发作前识别出易患坏死性软组织感染的个体。