Necrotizing fasciitis is a rapidly progressing and life-threatening bacterial infection
of deep subcutaneous tissues. Prompt diagnosis and surgical intervention decrease
morbidity and improve patient survival [
[1]
]. A paucity of physical examination findings in early disease hinders timely diagnosis
contributing to a high mortality rate of 25% to 30% [
[2]
]. Emergency department physicians rely on clinical suspicion to make the diagnosis
in critically ill patients as advanced imaging modalities such as computed tomography
or magnetic resonance imaging may result in an unacceptable delay to surgical intervention.
Emergency ultrasound is a quick and convenient imaging modality that can expedite
the diagnosis of necrotizing fasciitis in concerning soft tissue infections. We report
3 confirmed cases of necrotizing fasciitis in which emergency provider performed emergency
ultrasound identified findings highly suggestive of necrotizing fasciitis that included
fluid tracking along the fascial plane, diffuse fascial thickening, irregularity of
the fascia, and the presence of subcutaneous air leading to expedited diagnosis and
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References
- Predictors of mortality and limb loss in necrotizing soft tissue infections.Arch Surg. 2005; 140: 151-158
- Necrotizing fasciitis: current concepts and review of literature.J Am Coll Surg. 2009; 208: 279-288
- Ultrasonographic screening of clinically-suspected necrotizing fasciitis.Acad Emerg Med. 2002; 9: 1448-1451
- Necrotizing fasciitis: early sonographic diagnosis.J Clin Ultrasound. 2011; 39: 236-239
- Early diagnosis of necrotizing fasciitis with soft tissue ultrasound.Acad Emerg Med. 2009; 16: 1033
- Necrotizing fasciitis of the soft tissues: diagnostic imaging findings and literature review.Radiol Med. 2000; 99: 334-339
- Early diagnosis of necrotizing fasciitis by utilization of ultrasonography.Kaohsiung J Med Sci. 1996; 12: 235-240
- Necrotizing fasciitis: a challenging diagnosis.Eur J Emerg Med. 2007; 14: 50
Article Info
Publication History
Published online: January 23, 2013
Accepted:
September 18,
2012
Received in revised form:
September 4,
2012
Received:
May 2,
2012
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.