Necrotizing fasciitis in haematological patients: a different scenario

Abstract To describe and compare the characteristics of necrotizing fasciitis (NF) in patients with and without haematological malignancy. All adult patients diagnosed with NF and treated at our hospital were included (January 2010–March 2019). Diagnosis was based on intraoperative findings or consistent clinical/radiological characteristics, and patients were classified as group A (with haematological malignancy) or group B (without haematological malignancy). Student’s t (quantitative), Fisher’s exact (qualitative), and Kaplan-Meyer tests were used for the statistical analysis. The study included 29 patients: 8 in group A and 21 in group B. All haematological patients had severe neutropenia (0.2 [0.02–0.5] ×$ 10^{9} $ cells/L; p < 0.001) and positive blood cultures (100% vs. 61.9%; p = 0.04) at diagnosis. Gram-negative bacilli NF was more common in group A (87.5% vs. 9.5%; p = 0.001), predominantly due to Escherichia coli (50% vs. 9.5%; p = 0.056). Surgical treatment was less common in haematological patients (5 [62.5%] vs. 21 [100%]; p = 0.015). Overall, 9 (31%) patients died: 4 (50%) in group A and 5 (23.8%) in group B (p = 0.17). The univariate analysis showed that mortality tended to be higher (OR 3.2; 95%CI 0.57–17.7; p = 0.17) and to occur earlier (2.2 ± 2.6 vs. 14.2 ± 19.9 days; p = 0.13) in haematological patients. The LRINEC index > 6 did not predict mortality in either group. In our study, NF in patients with haematological malignancies was mainly due to Gram-negative bacilli, associated to high and early mortality rates. In our experience, the LRINEC scale was not useful for predicting mortality..

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:99

Enthalten in:

Annals of hematology - 99(2020), 8 vom: 12. Mai, Seite 1741-1747

Sprache:

Englisch

Beteiligte Personen:

Albasanz-Puig, A. [VerfasserIn]
Rodríguez-Pardo, D [VerfasserIn]
Pigrau, C. [VerfasserIn]
Lung, M. [VerfasserIn]
Roldan, E. [VerfasserIn]
Corona, P. S. [VerfasserIn]
Almirante, B. [VerfasserIn]
Ruiz-Camps, I. [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

Themen:

Bacteraemia
Gram-negative bacilli
Haematological malignancy
Necrotizing fasciitis
Neutropenia

RVK:

RVK Klassifikation

Anmerkungen:

© Springer-Verlag GmbH Germany, part of Springer Nature 2020

doi:

10.1007/s00277-020-04061-y

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2118249292

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