Diagnostic Challenges in Cellulitis and Role of LRINEC Score
Weny Rinawati, July Kumalawati

Soft-tissue infections are difficult to differentiate due to similarities at initial onset. The diagnosis of cellulitis is generally based on clinical examination, with other diagnoses for consideration. The clinical features of cellulitis can mimic abscesses, necrotizing fasciitis, and gangrene, so they are often difficult to distinguish. If the clinical findings are not accurate enough for necrotizing fasciitis, an assessment of the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score, radiologic examination, and biopsy can be performed to determine the risk or diagnosis. The LRINEC score was developed as a diagnostic tool to potentially aid practitioners in the early detection of necrotizing fasciitis. We report a case of a 55-year-old female, with a suppurative stage of cellulitis, classification class III, caused by Pseudomonas aeruginosa. The suppurative stage of cellulitis was difficult to distinguish with necrotizing fasciitis. The total LRINEC score for the patient was a strong predictor of necrotizing fasciitis, but the use of the LRINEC score must consider the presence of comorbidities and intervention for abnormal laboratory results because it can reduce the accuracy of the score.

Full Text: PDF     DOI: 10.15640/ijhs.v9n1a10