Friday, January 24, 2020

Necrotizing fasciitis and sodium

Q: Necrotizing fasciitis is more commonly associated with?

A) Hyponatremia
B) Hypernatremia

Answer: A

Although logic argues that sepsis and hypovolemia should cause hypernatremia, laboratory findings in necrotizing fascitis are more commonly associated with hyponatremia. In fact, the degree of hyperkalemia and hyponatremia correlates with the aggressiveness of the disease and should prompt clinicians to expedite the management.

Hyponatremia and part of hyperkalemia occur due to the degree of renal failure which is the surrogate of multiorgan failure. Hyponatremia is also exacerbated by fluid sequestration in affected soft tissue infections.




1. Espandar R, Sibdari SY, Rafiee E, Yazdanian S. Necrotizing fasciitis of the extremities: a prospective study. Strategies Trauma Limb Reconstr. 2011;6(3):121–125. doi:10.1007/s11751-011-0116-1 

2. Ogilvie CM, Miclau T. Necrotizing soft tissue infections of the extremities and back. Clin Orthop Relat Res. 2006;447:179–186. doi: 10.1097/01.blo.0000218734.46376.89.

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