ASSOCIATION ENTRE LE SCORE DE LRINEC ET LE TABLEAU CLINIQUE CHEZ LES PATIENTS HOSPITALISES POUR DERMO-HYPODERMITES BACTERIENNES A L’ADMISSION AU SERVICE DE DERMATOLOGIE DU CHU DE TREICHVILLE
Mots-clés :
Bacterial dermohypodermitis, LRINEC, necrotizing fasciitis, Côte d’IvoireRésumé
Introduction: Bacterial dermohypodermitis (BDH) is a common reason for hospitalization in Côte d’Ivoire. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score is a biological tool used to assess the risk of necrotizing fasciitis. This study aims to evaluate the association between the LRINEC score and the clinical characteristics of patients hospitalized for BDH in the dermatology department of the CHU of Treichville.
Methods: This was a descriptive and analytical cross-sectional study conducted over a period of eight months. All patients hospitalized for BDH who had a complete laboratory work-up allowing the calculation of the LRINEC score were included. Data collected included sociodemographic, clinical, biological, and outcome variables. The LRINEC score was calculated for each patient. Statistical analyses were performed with a significance threshold set at p < 0.05.
Results: Out of 198 hospitalized patients, 81 had BDH, representing a frequency of 41%. The sex ratio (M/F) was 1.5, and patients over 45 years of age accounted for 66%. Lesions were mostly located on the lower limbs. The main entry points were traumatic wounds (31%) and intertoe intertrigo (19%). Necrotizing forms of BDH (BDH-NF) represented 51% of cases. The LRINEC score was ≥6 in 33% of cases, suggesting a high risk of necrotizing fasciitis. Statistical analysis showed a significant association between a high LRINEC score and certain clinical signs, including previous episodes of BDH, presence of regional lymphadenopathy, local sensory loss, and absence of peripheral pulses (p < 0.05).
Conclusion: BDH is frequent in our context and poses a real diagnostic challenge. The significant association between certain clinical signs and a high LRINEC score underscores the value of this score as a complementary tool to the clinical diagnosis of necrotizing forms.
