LRINEC Score — Necrotising Fasciitis
Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC). Distinguishes NF from severe cellulitis using blood results.
Score interpretation
LRINEC ≤5: NF unlikely (NPV 96%)
→ Treat as severe cellulitis; IV antibiotics; close monitoring; urgent review if deteriorating
LRINEC 6–7: Intermediate risk
→ Close clinical observation; CT/MRI to assess deep tissue; surgical opinion; do not delay surgery if clinical deterioration
LRINEC ≥8: High risk of necrotising fasciitis (PPV 93%)
→ Urgent surgical exploration; do not delay for imaging if clinical diagnosis; broad-spectrum antibiotics; ICU; plastic/orthopaedic surgery
Interpretation bands for the LRINEC. Apply clinical judgement and local guidance.
References
- Wong CH, et al. The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Crit Care Med. 2004;32(7):1535-1541.
Related
Curated clinical cross-links plus same-class fallbacks.
- Cefalexin · First-Generation Cephalosporin — Skin / Soft Tissue / UTI
- Triamcinolone Acetonide 10–40mg (Kenalog) · Corticosteroid (Intra-articular / Soft Tissue)
- Protamine Sulphate (Heparin Reversal) · Heparin Reversal / Cardiac Surgery
- Alteplase · Recombinant Tissue Plasminogen Activator (Thrombolytic)
- Liquid paraffin with white soft paraffin and wool alcohols · Emollient
- Retinol palmitate with white soft paraffin, light liquid paraffin, liquid paraffin and wool fat · Ocular lubricant ointment
- Hip Fracture Pathway · NICE CG124; BPT
- Cauda Equina Syndrome · Society of British Neurological Surgeons; BOA — Best Practice
- Knee Soft Tissue Injury (ACL / MCL / Meniscus) · BOA; Royal College of Surgeons
- Shoulder Dislocation · BOA; RCEM
- Scaphoid Fracture · BOA; BSSH
- Pelvic Fracture · BOA; ATLS; NICE NG39
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.