Necrotizing Fasciitis (cont.)
Necrotizing Fasciitis Diagnosis
The diagnosis of necrotizing fasciitis is often presumptively made initially
based on the patient's history and physical examination findings. Though there
are several laboratory tests and imaging studies that may assist in making the
diagnosis of necrotizing fasciitis, immediate results may not be readily
available. Therefore, a high index of suspicion in any patient with symptoms or
signs suggestive of necrotizing fasciitis should prompt immediate consultation
with a surgeon in order to expedite management.
- Laboratory testing will include various blood tests such as a complete
blood count (CBC), which may reveal an elevated white blood cell count (WBC).
Electrolyte panels, blood cultures, and other blood tests are also generally
obtained. However, the results of these blood tests cannot be solely relied upon
to make an immediate diagnosis.
- Imaging studies such a CT scanning,
MRI, and ultrasound have all been used
successfully to identify cases of necrotizing fasciitis. They may be used when
signs are equivocal or the diagnosis is in doubt. These modalities may help
identify areas of fluid collections, inflammation and gas within the
soft tissue, in addition to helping delineate the extent of the infection.
Although occasionally plain radiographs (X-rays) may demonstrate gas in the
soft tissue, they are considered less useful and of little value. Obtaining
imaging studies should not delay definitive treatment in those cases highly
suggestive of necrotizing fasciitis.
- Tissue culture, tissue biopsy, and Gram stain results can help definitively
identify the organism(s) responsible for the infection, and this can help guide
appropriate antibiotic therapy.
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