Development of a Computed Tomography-Based Scoring System for Necrotizing Soft-Tissue Infections

McGillicuddy, Edward A.; Lischuk, Andrew; Schuster, Kevin M.; Kaplan, Lewis J.; Maung, Adrian A.; Lui, Felix Y.; Bokhari, Sabahat; Davis, Kimberly A.

doi:10.1097/ta.0b013e3182134a76

Cited by 44 publications

(46 citation statements)

References 24 publications

(20 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Numerous studies have evaluated the usefulness of laboratory and imaging tests for diagnosing NSTI. Laboratory markers, such as hematocrit, white blood cell (WBC) count, and levels of serum sodium, bicarbonate, glucose, lactate, and hemoglobin, 9,11,12,14,19 have been inconsistently reported to be prognostic for NSTI-associated mortality. In 2004, the Laboratory Risk Indicator for Necrotizing Fasciitis score was developed as a tool for diagnosing necrotizing fasciitis.…”

mentioning

confidence: 99%

“…16 The 6 components of this score include WBC count and levels of glucose, sodium, hemoglobin, serum creatinine, and C-reactive protein. Others propose using computed tomography 20 and computed tomography-based scoring systems 19 to aid in diagnosing NSTI. Despite recent advancements in our understanding of NSTI, early recognition and diagnosis of NSTI remain challenging.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Immunocompromised Status in Patients With Necrotizing Soft-Tissue Infection

et al. 2013

View full text Add to dashboard Cite

AND RELEVANCE Immunocompromised status in patients with NSTI in this study is associated with delays in diagnosis and surgical treatment and with higher NSTI-associated in-hospital mortality. At presentation, immunocompromised patients may fail to exhibit typical clinical and laboratory signs of NSTI. Physicians caring for similar patient populations should maintain a heightened level of suspicion for NSTI and consider early surgical evaluation and treatment.

show abstract

mentioning

confidence: 99%

mentioning

confidence: 99%

Immunocompromised Status in Patients With Necrotizing Soft-Tissue Infection

et al. 2013

View full text Add to dashboard Cite

show abstract

“…This technique tends to overestimate the involvement of deep tissues; therefore, it cannot be used to reliably distinguish between necrotizing cellulitis and deeper infection. [7][8][9] Tissue biopsies provide reliable results in NSTIs. It is based on the observation of histological changes that include tissue necrosis, polymorphonuclear infiltration, vascular thrombosis and sometimes microorganisms within the destroyed tissue.…”

Section: Discussionmentioning

confidence: 99%

Impact of clinical interventions in the timely diagnosis and therapeutic approach of necrotizing soft tissue infections

Mora

Murillo

Soto

et al. 2019

IJMBOA

View full text Add to dashboard Cite

This review aims to analyze the role of specific diagnostic and therapeutic interventions with a positive impact on the necrotizing soft tissue infection approach, we underline strategies that-conduct in a timely manner-may prevent patients death, as well as to avoid limb loss. We discuss the usefulness of clinical findings, imaging and biochemical markers in the address of infection. Also, we present an analysis of hyperbaric oxygen therapy in the role of the disease.

show abstract

“…Recently, a scoring system was introduced that performed well in diagnosing NSTI. Based on the presence of the five criteria, fascial air, muscle/fascial edema, fluid tracking, lymphadenopathy and subcutaneous edema, a score can be calculated such that a higher score is highly suggestive of NSTI [40]. It should be added that this score relies mostly on the presence of gas, a sign that may only develop later in the course of the disease, and requires radiological expertise.…”

Section: Diagnostic Adjunctsmentioning

confidence: 99%

Management of necrotizing skin and soft tissue infections

Waele¹

2012

Expert Review of Anti-infective Therapy

View full text Add to dashboard Cite

Although rare, necrotizing skin and soft tissue infections can be devastating infections that are difficult to diagnose and challenging to manage. Clinical presentation is often insidious, and a low index of suspicion is critical. Various diagnostic tools, such as scoring systems or imaging techniques, have been introduced, but none is convincingly superior to sound clinical judgment. Early diagnosis allows early adequate therapy that includes antibiotic therapy, critical care support, specific interventions such as intravenous immunoglobulin in selected patients and, most importantly, early source control. Empirical antibiotic therapy should cover a broad range of both Gram-negative and Gram-positive aerobic and anaerobic microorganisms, and clindamycin is recommended when group A Streptococcus is a suspected pathogen.

show abstract

Development of a Computed Tomography-Based Scoring System for Necrotizing Soft-Tissue Infections

Abstract: We have developed a CT scoring system that is both sensitive and specific for the diagnosis of NSTIs. This system may allow clinicians to more accurately diagnose NSTIs. Prospective validation of this scoring system is planned.

Cited by 44 publications

References 24 publications

Immunocompromised Status in Patients With Necrotizing Soft-Tissue Infection

Immunocompromised Status in Patients With Necrotizing Soft-Tissue Infection

Impact of clinical interventions in the timely diagnosis and therapeutic approach of necrotizing soft tissue infections

Management of necrotizing skin and soft tissue infections

Contact Info

Product

Resources

About