MDCalc

LRINEC Score for Necrotizing Soft Tissue Infection

Screens for necrotizing soft tissue infections.

If high suspicion for necrotizing fasciitis through clinical history and physical exam, do not calculate a LRINEC score and go straight to operative debridement.
Note: Use with caution, as the LRINEC Score has performed poorly in external validation, most recently in Neeki 2017.

C-reactive protein

White blood cell count (× 1,000/µL)

Hemoglobin (g/dL)

Sodium (mEq/L)

Creatinine

Glucose

Result:

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Advice
  • All patients with a high clinical suspicion for necrotizing fasciitis should receive immediate surgical consultation for potential operative debridement.
  • Consider calculating a LRINEC score to distinguish patients with severe cellulitis/abscess vs necrotizing fasciitis.
Management
  • Prompt fluid resuscitation and antibiotic administration are crucial in the treatment of necrotizing fasciitis.
  • Consider early surgical consultation in borderline cases.
Critical Actions
  • A LRINEC score ≥6 is a reasonable cut-off to rule in necrotizing fasciitis, but a LRINEC <6 does not rule out the diagnosis.
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