Sorry there was no case on Monday - I got pulled to cover the cardiothoracic ICU and it got really busy.
You are processing samples in the lab when you get the following tests: CRP 160 mg/L, WBC 30/mm3, hemoglobin 10 g/dL, sodium 132, creatinine 2.0 mg/dL, glucose 200 mg/dL. You briefly look up the clinical "one-liner" and it says: "Young man, otherwise healthy, complaining of pain."
Challenge: What do you think it is?
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Lab Rat
These values are all components of the LRINEC score, the laboratory risk indicator for necrotizing fasciitis. Although obviously a lot of various illnesses can cause this constellation of lab abnormalities, I was getting at this score, published in 2004, which can discern necrotizing fasciitis from other soft tissue infections.
Source: Wong, et. al. The LRINEC score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Critical Care Medicine. 2004.
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