Necrotizing Fasciitis in Hematological Patients: Enterobacteriaceae Predominance and Limited Utility of Laboratory Risk Indicator for Necrotizing Fasciitis Score

Rui Min Foo; Moon Ley Tung; Li Mei Poon; Douglas Chan; Nares Smitasin; Liang Piu Koh; Wee Joo Chng; Louis Yi Ann Chai

doi:10.1093/ofid/ofv081

Necrotizing Fasciitis in Hematological Patients: Enterobacteriaceae Predominance and Limited Utility of Laboratory Risk Indicator for Necrotizing Fasciitis Score

Open Forum Infect Dis. 2015 Jun 12;2(2):ofv081. doi: 10.1093/ofid/ofv081. eCollection 2015 Apr.

Authors

Rui Min Foo¹, Moon Ley Tung², Li Mei Poon², Douglas Chan³, Nares Smitasin¹, Liang Piu Koh², Wee Joo Chng⁴, Louis Yi Ann Chai¹

Affiliations

¹ Division of Infectious Diseases , University Medicine Cluster, National University Health System , Singapore.
² Department of Haematology-Oncology , National University Cancer Institute of Singapore, National University Health System.
³ Department of Laboratory Medicine , National University Hospital , Singapore.
⁴ Department of Haematology-Oncology , National University Cancer Institute of Singapore, National University Health System ; Faculty of Medicine , Yong Loo Lin School of Medicine, National University of Singapore ; Cancer Science Institute of Singapore , National University of Singapore.

Abstract

Immune suppression is a recognized risk factor for necrotizing fasciitis. In patients with hematological malignancies, a profoundly immunocompromised group, the predominant causative organisms are Gram negative. Clinical presentation and outcomes in these patients are similar to the immunocompetent. The Laboratory Risk Indicator for Necrotizing Fasciitis score is not reliable for risk stratification of the disease.

Keywords: Gram negative; hematological malignancy; immunocompromised host; necrotizing fasciitis.