Utilidad de la procalcitonina sérica para la discriminación temprana entre fascitis necrosante y celulitis de las extremidades: serie de casos y revisión de la literatura.

Objective: to assess the usefulness of a risk scale based on serum procalcitonin when compared with the LRINEC scorein the early discrimination between necrotizing fasciitis (NF) and extremities cellulite.Material and method: retrospective study, between 2009 and 2017, of all patients with the confirmed diagnosis of NF inone limb (N = 10). The findings of these patients were compared with those of 23 patients who were admitted for severecellulitis of limbs in the same period. The variables related to each group were analyzed. Using the area under the curve(AUC), the discrimination capacity for NF diagnosis of two scales was compared, one based on procalcitonin levels andanother based on the LRINEC score.Results: the area under the curve was greater for the risk categorized by procalcitonin levels. When analyzing the LRINECscore and procalcitonin levels as continuous variables, the latter also presented a larger area under the curve. The cut-offpoint with the greatest area under the curve was that corresponding to> 0.87 ng / ml of procalcitonin (sensitivity of 100%and specificity of 82.6%) and score 5 on the LRINEC score (sensitivity of 80% and specificity of 82.6%).Conclusion: in our sample the level of procalcitonin and the scale based on this level has been shown as a more sensitiveand at least as specific tool as the LRINEC scale for early discrimination between NF and a cellulite of the extremities.

Objective: to assess the usefulness of a risk scale based on serum procalcitonin when compared with the LRINEC scorein the early discrimination between necrotizing fasciitis (NF) and extremities cellulite.Material and method: retrospective study, between 2009 and 2017, of all patients with the confirmed diagnosis of NF inone limb (N = 10). The findings of these patients were compared with those of 23 patients who were admitted for severecellulitis of limbs in the same period. The variables related to each group were analyzed. Using the area under the curve(AUC), the discrimination capacity for NF diagnosis of two scales was compared, one based on procalcitonin levels andanother based on the LRINEC score.Results: the area under the curve was greater for the risk categorized by procalcitonin levels. When analyzing the LRINECscore and procalcitonin levels as continuous variables, the latter also presented a larger area under the curve. The cut-offpoint with the greatest area under the curve was that corresponding to> 0.87 ng / ml of procalcitonin (sensitivity of 100%and specificity of 82.6%) and score 5 on the LRINEC score (sensitivity of 80% and specificity of 82.6%).Conclusion: in our sample the level of procalcitonin and the scale based on this level has been shown as a more sensitiveand at least as specific tool as the LRINEC scale for early discrimination between NF and a cellulite of the extremities.